Where is the payer address or payer information typically entered on the UB-04 form according to these fields?

Where is the payer address or payer information typically entered on the UB-04 form according to these fields?

• A. FL 74
• B. FL 76
• C. FL 71
• D. FL 72 A-C

Answer: (B)

Payer information is collected to identify who pays the claim and where to send remittance. On the UB-04, the field designated for the payer’s name and address is Form Locator 76. Enter the payer’s official name and full mailing address there so the claim is correctly associated with the insurer and routed for payment. The other fields referenced are used for different data elements on the form and are not where the payer address is entered, which is why this field is the best choice.

Payer information is collected to identify who pays the claim and where to send remittance. On the UB-04, the field designated for the payer’s name and address is Form Locator 76. Enter the payer’s official name and full mailing address there so the claim is correctly associated with the insurer and routed for payment. The other fields referenced are used for different data elements on the form and are not where the payer address is entered, which is why this field is the best choice.