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Field 11 c - Insurance Plan Name or Program Name
Posted by Dan Perrine, Last modified by Dan Perrine on 28 March 2018 06:49 AM

The “Insurance Plan Name or Program Name” is the name of the plan or program of the insured as indicated in Item Number 1a.

INSTRUCTIONS: Enter the name of the insurance plan or program of the insured. Some payers require an identification number of the primary insurer rather than the name in this field.

MEDICARE - Enter the 9-digit PAYERID number of the primary insurer. If no PAYERID number exists, then enter the complete primary payer's program or plan name. If the primary payer's EOB does not contain the claims processing address, record the primary payer's claims processing address directly on the EOB. This is required if there is insurance primary to Medicare that is indicated in item 11.

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