What is the correct format for entering a patient's or policyholder's name in Block 2 or 4 on the CMS-1500?

The correct format for entering a patient's or policyholder's name in Block 2 or 4 on the CMS-1500 is to list the last name first, followed by the first name and middle initial, all separated by commas, which aligns with option A. This order is essential for clarity and consistency within medical billing practices, as it allows for the clear identification of the individual associated with the insurance policy.

Using the last name first helps prevent confusion, particularly when names are being processed in systems or compared with records where the last name is typically the principal identifier. This format adheres to the requirements set forth by the National Uniform Claim Committee (NUCC) for electronic and paper claim submissions.

The other formats mentioned do not follow this structured approach. For instance, placing the first name first can lead to difficulties in identification, especially in systems that sort or organize names alphabetically by surname. The inclusion of commas or lack thereof can also result in inconsistencies, which can complicate record-keeping and insurance verification processes.

Thus, this standardized naming convention is critical in ensuring all claims processed using the CMS-1500 form maintain accuracy and efficiency in patient and policyholder identification.