HCFA-1500 Box 1 - Insurance Type

On the HCFA-1500 form, box 1 is designated for the type of health insurance of the claim. Depending on the insurance type, there are seven plan types to choose from.

• Medicare
• Medicaid
• Tricare
• ChampVA
• Group Health Plan
• FECA BLK Lung
• Other

In our example below, we marked 'Other' in box 1 as that most accurately represents this claim type. We often choose 'Other' in Box 1 when the insurance is a Commerical payer or when it doesn't match one of the other types.

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

In the X12 837 format, the insurance type box information goes in the 2000B Subscriber Information Loop - SBR segment. More specifically, the HCFA Box 1 insurance type data goes in the SBR09, which is also known as the Claim Filing Indicator Code.

The example below shows the 2000B Subscriber Information Loop - SBR segment. In our sample, we have the value CI for the SBR09, which means Commercial. This is just one example value, there are other available codes depending on the insurance type. For additional information on the X12 837 format, we strongly recommend consulting the official X12 materials.

Sample 837P (5010) - 2000B - Subscriber Information

HCFA-1500 Form Box Locations

• HCFA-1500 Box 0 - Carrier Block
• HCFA-1500 Box 1 - Insurance Type [You are Here]
• 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