What format is used for entering the insured's name on the form?

What format is used for entering the insured's name on the form?

• A. LAST NAME FIRST NAME MIDDLE INITIAL format
• B. First name Last name middle initial format
• C. First name Last name format
• D. Last name, First name middle initial

Answer: (A)

The insured’s name is entered in a surname-first format: LAST NAME FIRST NAME MIDDLE INITIAL, all in uppercase. This ordering prioritizes the surname for easy indexing and matching in payer systems, and the middle initial helps distinguish individuals with common names. Using a first-name-first order or adding a comma would disrupt the standard data entry and automated processing used on a UB-04 form.

The insured’s name is entered in a surname-first format: LAST NAME FIRST NAME MIDDLE INITIAL, all in uppercase. This ordering prioritizes the surname for easy indexing and matching in payer systems, and the middle initial helps distinguish individuals with common names. Using a first-name-first order or adding a comma would disrupt the standard data entry and automated processing used on a UB-04 form.