When submitting a UB-04 claim with multiple payers, what information should be included?

• A. Only the primary payer details are submitted.
• B. Include primary payer details and any secondary payments, and use coordination of benefits fields.
• C. Ignore secondary payments and COB fields.
• D. Submit payer details in a separate attachment.

Answer: (B)

When a UB-04 claim involves more than one payer, you must capture the entire payer sequence and how each payer contributes, using the Coordination of Benefits (COB) fields. The primary payer is billed first and their payment is applied, then any secondary payer is billed for remaining covered charges according to COB rules. Reporting both the primary payer details and any secondary payments within the same claim, and using the COB fields to indicate the order and amounts, ensures the claim is adjudicated correctly and prevents gaps or duplicate payments. Submitting only the primary payer omits the additional responsible party, and ignoring the COB fields would fail to convey how the claim should be coordinated across payers. Attaching payer details separately isn't how UB-04 handles payer information; the COB fields are designed to capture multiple payer relationships on one claim.