UB04 Field 58: Insured's Name

Overview

Field 58 (Box 58) on the UB-04 claim form is labeled “Insured’s Name.” The Maryland Medicaid UB-04 Hospital Billing Instructions include this field in their table of contents, listing “FL 58 Insured’s Name” on page 43 of the document. The source does not provide any additional definition, usage guidance, or formatting instructions for this field. It merely appears in the document’s table of contents alongside other fields such as FL 59 (Patient Relationship to Insured) and FL 60 (Insured’s Unique ID). No explanatory text about the purpose of Field 58 is supplied in the excerpt. ^[1]

Because the source contains only the field label and its position in the document, no further details about the meaning of “Insured’s Name” or how it should be completed can be derived from the provided material. The field is listed without any accompanying notes, examples, or references to specific billing scenarios. Therefore, this overview is limited to confirming that Field 58 exists in the Maryland Medicaid UB-04 instructions and that the document assigns it the title “Insured’s Name.” ^[1]

When to Use

The Maryland Medicaid UB-04 Hospital Billing Instructions do not specify when Field 58 should be used. The table of contents excerpt simply lists “FL 58 Insured’s Name” without any conditionality, such as “Required” or “If Applicable.” The user-provided field description indicates “Inpatient: If Applicable” and “Outpatient: If Applicable,” but this information is not present in the source document. Since the source does not mention any specific circumstances for completing Field 58, no determination can be made about when it is necessary to fill in the insured’s name. The source only confirms that the field exists in the document’s layout. ^[1]

Step-by-Step Claim Example

The provided source contains no step-by-step instructions or example for completing Field 58. The table of contents references page 43 for “FL 58 Insured’s Name,” but the actual content of that page is not included in the excerpt. Without access to the full text of the Maryland Medicaid UB-04 instructions, it is impossible to provide a concrete claim example or walkthrough for this field. The source does not illustrate how to format the insured’s name, what payer systems expect, or how the field interacts with other data elements. Consequently, no step-by-step example can be constructed from the available information. ^[1]

Common Mistakes & Audit Red Flags

Because the source lacks any guidance on Field 58, common mistakes and audit red flags cannot be identified from the provided text. The Maryland Medicaid UB-04 table of contents does not describe errors, rejections, or compliance issues related to this field. No warnings about missing, incorrect, or mismatched insured names are included. Therefore, any discussion of potential billing errors or audit triggers for Field 58 would be speculation outside the source material. The only verifiable fact is the field’s existence in the document. ^[1]

Related Codes/Fields

The Maryland Medicaid UB-04 table of contents places Field 58 adjacent to several other fields that are part of the claim’s payer/insured information section. The following table lists fields mentioned in the source that appear in the same context as Field 58. Note that the source does not define relationships between these fields; it only shows their sequence in the document.

Field	Description (from source)	Source
FL 58	Insured’s Name	[1]
FL 59	Patient Relationship to Insured	Same document, page 43
FL 60	Insured’s Unique ID	Same document, page 44
FL 61	Insured’s Group Name	Same document, page 44
FL 62	Insured’s Group Number	Same document, page 44

No further cross‑field relationships, edits, or dependencies are provided in the source. ^[1]

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References

[1] Maryland Medicaid — FL 58 — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf