Which items should be verified to prevent missing payer information before submitting a UB-04?

• A. Payer name, policy number, and group number against the patient record and payer agreement.
• B. Only the primary payer name.
• C. The date of service only.
• D. The patient's contact information.

Answer: (A)

Verifying payer details up front ensures the claim goes to the correct insurer and is adjudicated accurately. The payer name, policy number, and group number are the key identifiers that link the patient’s chart to the specific contract and benefits with the insurer. By cross-checking these items against the patient’s record and the payer agreement, you confirm that the policy is active, the subscriber is correct, and the group under which benefits are billed matches what the payer expects. This reduces the risk of claim denials or delays due to missing or mismatched payer information.

Why the other options aren’t enough: using only the primary payer name omits the policy and group numbers, which are essential for pinpointing the exact policy and benefits and for proper claim routing. The date of service alone does not identify the payer or the specific policy under which the services were provided. The patient’s contact information is not used to determine payer eligibility or to process the claim.