HCFA-1500 Box 0 - Carrier Block

The 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. See the highlighted parts of the screenshot below.

Note: While we labeled this part of the form as box 0, there really is no box 0 on the HCFA-1500 form. We did this to keep the naming consistant with all the other boxes that are labeled with numeric values. You can refer to this location as the top of the HCFA form or reference it by using the name carrier block and/or payer information.

In this example, we used 'Cigna' as the primary payer. The carrier block contains the payer name, address, city/state/zip and one other item located in front of the payer name. This numeric number '62308' is known as the payer id code, which is commonly placed in front of the payer name or payer address when sending electronic claims in the HCFA-1500 format. You can read additional information on what are payer id codes.

So far, we talked about what the carrier block on the HCFA-1500 form is and the information used to populate this location. In the next section, we'll briefly discuss the carrier block in relation to the X12 837 format.

In the X12 837 format, the carrier block information goes in the 2010BB Payer Name Loop - NM1/N3/N4 segments. We have one example of the 2010BB Payer Name Loop below. For additional information on the X12 837 format, we strongly recommend consulting the official X12 materials.

Sample 837P (5010) - 2010BB - Payer Name Loop

HCFA-1500 Form Box Locations

• HCFA-1500 Box 0 - Carrier Block [You are Here]
• HCFA-1500 Box 1 - Insurance Type
• HCFA-1500 Box 1a - Insured's ID Number
• HCFA-1500 Box 2 - Patient's Name
• HCFA-1500 Box 3 - Patient's Birth Date and Sex
• HCFA-1500 Box 4 - Insured's Name
• HCFA-1500 Box 5 - Patient's Address
• HCFA-1500 Box 6 - Patient Relationship to Insured
• HCFA-1500 Box 7 - Insured's Address
• HCFA-1500 Box 8 - Reserved For NUCC Use

Grab a sample of the HCFA-1500 claim form here - HCFA 02/12 Claim Form