UB04 Field 61: Insured Group Name

Overview

Field 61 on the UB‑04 claim form is designated as “Insured’s Group Name” in the Maryland Medicaid UB04 Hospital Billing Instructions. ^[1] The field appears in the payer/insured information block of the form, positioned between Field 60 (Insured’s Unique ID) and Field 62 (Insured’s Group Number). ^[1] The source document lists this field as part of a sequential table of contents that covers all UB‑04 form locators from FL 1 through FL 79. ^[1] No additional definition, usage instructions, or requirement status (e.g., required vs. optional) is provided in the excerpt. ^[1] The field name itself indicates that it is intended to capture the name of the group insurance plan under which the insured is covered, but the source does not elaborate on the specific data elements or formatting rules. ^[1]

When to Use

The Maryland Medicaid UB04 instructions do not specify any particular circumstances under which Field 61 must be completed. ^[1] The source document simply lists the field name without a requirement indicator (e.g., “Required” or “Conditional”). ^[1] In the absence of explicit guidance from this source, providers should refer to their payer contracts or the National Uniform Billing Committee (NUBC) standards for when to populate the insured’s group name. ^[1] The field is typically used when the patient’s insurance is provided through an employer or other group plan, and the group name differs from the individual policyholder name. ^[1] However, because the source does not confirm this usage, the statement is an inference based on the field label alone. ^[1] For Maryland Medicaid specifically, the instructions may treat this field as optional or not applicable, as the payer is a government program rather than a commercial group plan. ^[1]

Step-by-Step Claim Example

The Maryland Medicaid source does not provide a step-by-step example for completing Field 61. ^[1] Therefore, no example can be constructed using only the provided reference. ^[1] In practice, if a payer requires the insured’s group name, the provider would enter the exact name as it appears on the insurance card (e.g., “ABC Corporation Health Plan”). ^[1] The source does not specify character limits, alphanumeric rules, or whether abbreviations are acceptable. ^[1] Without further documentation from Maryland Medicaid or the NUBC, the claim example cannot be validated against this source. ^[1] Providers should consult the full Maryland Medicaid UB04 manual or the payer’s specific billing guidelines for an authoritative example. ^[1]

Common Mistakes & Audit Red Flags

The Maryland Medicaid source does not list any common mistakes or audit red flags for Field 61. ^[1] Because the field is simply named without additional instructions, potential errors such as entering the insured’s individual name instead of the group name, using incorrect formatting, or leaving the field blank when required cannot be confirmed from this reference. ^[1] Auditors might flag claims where Field 61 contains data inconsistent with the group number in Field 62, but the source does not address this. ^[1] Similarly, the absence of a group name when the payer is a commercial insurer could be considered a red flag, but again the source is silent. ^[1] Providers should rely on payer-specific audit guides and the NUBC official specifications for a comprehensive list of common errors. ^[1]

Related Codes/Fields

The following table lists the fields immediately surrounding Field 61 as they appear in the Maryland Medicaid UB04 Hospital Billing Instructions table of contents. ^[1]

Field Number	Field Name (as listed in source)
FL 58	Insured’s Name
FL 59	Patient Relationship to Insured
FL 60	Insured’s Unique ID
FL 61	Insured’s Group Name
FL 62	Insured’s Group Number
FL 63	Treatment Authorization Code
FL 64	Document Control Number (DCN)
FL 65	Employer Name (of the Insured)

These fields are part of the payer/insured information block and are often completed together to identify the responsible party and their coverage. ^[1] The source does not provide cross-references or dependencies between these fields. ^[1]

---

References

[1] Maryland Medicaid — FL 61 — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf