Payer Information on the UB-04

Confirm the current payer record

Use the plan name, member/insured information, and other required identifiers from the current eligibility and billing record.

Keep payer order straight

Primary, secondary, and tertiary coverage positions should match the office's coordination-of-benefits information. Do not carry payer order forward automatically from an earlier episode.

Match remittance and follow-up records

Consistent payer information helps staff reconcile claim submissions, remittances, and corrected claims with the same account.

Institutional-claim review

• Confirm payer order and plan information before printing or submitting the institutional claim.
• Use the patient’s current coverage record—not a generic payer name—as the source.
• Keep payer information synchronized with follow-up and remittance records.

Payer order affects more than the address block

Institutional claims can involve primary, secondary, and other coverage information. The payer sequence used on the claim should match the patient’s current coverage and the office’s coordination-of-benefits workflow. When coverage changes, update the central insurance record so the new payer information reaches claim preparation, follow-up, and remittance posting consistently.

Sources and verification

Use the CMS institutional-claim sources below for current CMS-1450/UB-04 guidance, then apply the payer’s rules for the facility claim.

• CMS institutional paper claim form (CMS-1450/UB-04)
• CMS Medicare Claims Processing Manual, Chapter 25

Related guides

• Saving Facility Information for UB-04 Claims
• Attending Provider Information on the UB-04
• Understanding Type of Bill on the UB-04