HCFA-1500 Box 3 - Patient's Birth Date and Sex
February 08, 2024On the HCFA-1500 form, box 3 is designated for the patient's birth date and sex. This is the patient who the services were rendered to for the claim. Check the box for the patient's sex and enter the patient's birth date using the complete 4-digit year.
HCFA-1500 Box 2 - Patient's Name
January 29, 2024On the HCFA-1500 form, box 2 is designated for the patient's name (Last, First, Middle). This is the patient who the services were rendered to for the claim. The name should be entered exactly as it appears on the patient's member card.
HCFA-1500 Box 1a - Insured's ID Number
January 01, 2024On the HCFA-1500 form, box 1a is designated for the insured's ID Number. This will normally be the insured id number for the subscriber of the claim. While not typical, some payers may assign unique identification numbers to each enrollee/dependent and require the specific number of the member receiving services instead of the insured's number. See the members insurance card and/or use an Eligibility check service to verify the information prior to populating.
HCFA-1500 Box 1 - Insurance Type
December 30, 2023On the HCFA-1500 form, box 1 is designated for the type of health insurance of the claim. There are seven types of plans to choose from. Medicare, Medicaid, Tricare, ChampVA, Group Health Plan, FECA BLK Lung, Other.
HCFA-1500 Box 0 - Carrier Block
November 28, 2023The space at the top area of the HCFA-1500 form, known as the carrier block, is typically reserved for the payer information of the claim. The primary payer of the subscriber should go here, which will contain the destination information of where the claim should be routed to for processing.