UB04 Field 8a: Patient Name

Overview

Field 8a on the UB-04 (CMS-1450) claim form is labeled "Patient Identifier" and is used to report the patient's identification number. This field is classified as Situational, meaning it is only required under specific circumstances. According to the Carelon Behavioral Health guide, Field 8a "is for the patient’s identification number. Only required if the patient’s ID on their identification card is different than the subscriber’s." ^[1]

The Tennessee Hospital Discharge Data System manual provides additional context, noting that the patient's first name is entered "as given in FL 8A" and that the field captures "Patient Name – First and Last" for data reporting purposes. ^[2] However, it is important to distinguish between the UB-04 claim form field (8a) and the data reporting field referenced in the Tennessee manual, as the UB-04 field is specifically for the patient identifier, not the patient name.

It is a situational field that should only be completed when the patient's identification number differs from the subscriber's (the primary insured person). When the patient is the same as the subscriber, this field is typically left blank.

When to Use

Field 8a should be used only when the patient's identification number on their insurance card is different from the subscriber's identification number. This situation commonly occurs in the following scenarios:

1. Dependent children: When a child is covered under a parent's insurance plan, the child's patient ID number may differ from the parent's subscriber ID number. In this case, enter the child's unique patient identifier in Field 8a.

2. Spouses: When a spouse is covered under the other spouse's insurance plan, the spouse's patient ID may differ from the subscriber's ID.

3. Other dependents: Any dependent who has a different identification number than the primary subscriber.

If the patient is the same as the subscriber (e.g., an individual with their own insurance policy), Field 8a is not required and should be left blank. The Carelon guide explicitly states this field is "Only required if the patient’s ID on their identification card is different than the subscriber’s." ^[1]

Providers should verify the patient's insurance card to determine if a separate patient identifier exists.

Step-by-Step Claim Example

Scenario: A 10-year-old child, Jane Doe, is covered under her mother's employer-sponsored health insurance plan. The mother's subscriber ID is "ABC12345," but Jane's patient ID on the insurance card is "ABC12345-01." The provider is submitting an outpatient claim for Jane's visit.

Step 1: Obtain the patient's insurance card Review the patient's insurance card to identify both the subscriber ID and the patient ID. In this case, the subscriber ID is "ABC12345" and the patient ID is "ABC12345-01."

Step 2: Determine if Field 8a is needed Since Jane's patient ID ("ABC12345-01") differs from her mother's subscriber ID ("ABC12345"), Field 8a is required.

Step 3: Complete Field 8a Enter Jane's patient identification number in Field 8a: ABC12345-01

Step 4: Complete Field 8b (Patient Name) Enter the patient's name in Field 8b: Doe, Jane (last name, first name, middle initial if applicable) ^[1]

Step 5: Complete other required fields Fill in all other required fields on the UB-04 form, including patient address (Field 9a), birth date (Field 10), sex (Field 11), and other applicable fields.

Step 6: Submit the claim Submit the completed UB-04 claim form with Field 8a containing the patient's unique identifier.

Completed Field 8a entry: ABC12345-01

Common Mistakes & Audit Red Flags

1. Leaving Field 8a blank when required: The most common mistake is failing to complete Field 8a when the patient's ID differs from the subscriber's. This can result in claim rejection or denial because the payer cannot properly identify the patient.

2. Entering the subscriber ID instead of the patient ID: Some billers mistakenly enter the subscriber's ID number in Field 8a when the patient is a dependent. Always verify the patient's specific ID on the insurance card.

3. Using Field 8a for patient name: Field 8a is for the patient identifier, not the patient name. The patient name should be entered in Field 8b. The Tennessee manual's reference to "Patient Name – First and Last" in FL 8A may cause confusion, but this refers to a different data reporting context, not the UB-04 claim form. ^[2]

4. Including unnecessary information: Do not enter dashes, spaces, or special characters unless they are part of the patient's actual ID number. Enter only the identifier as it appears on the insurance card.

5. Audit red flag – inconsistent patient identifiers: If Field 8a contains a patient ID that does not match the subscriber ID in other fields (e.g., Field 60 – Insured's ID Number), this can trigger an audit. Ensure consistency across all fields.

6. Audit red flag – missing Field 8a for dependents: Payers may flag claims for dependents where Field 8a is blank, as this suggests the patient ID was not properly verified. This can lead to payment delays or denials.

7. Confusing Field 8a with Field 3a (Patient Control Number): Field 3a is for the provider's internal patient account number, while Field 8a is for the insurance company's patient identifier. Do not mix these up.

Related Codes/Fields

Field Number	Field Name	Relationship to Field 8a
3a	Patient Control Number	Provider-assigned account number; distinct from the insurance patient ID in Field 8a
8b	Patient Name	Required field for patient's last, first, and middle initial; complements the patient identifier in Field 8a
9a-9e	Patient Address	Required fields for patient's street address, city, state, ZIP, and country
10	Patient Birth Date	Required field for patient's date of birth (MMDDCCYY format)
11	Sex	Required field for patient's sex
60	Insured's ID Number	Contains the subscriber's ID number; Field 8a should contain the patient's ID if different
61	Insured's Name	Contains the subscriber's name; Field 8b contains the patient's name if different
67	Principal Diagnosis Code	Diagnosis code for the patient's condition; links to the patient identified in Field 8a

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References

[1] Carelon UB04 Tips — https://www.carelonbehavioralhealth.com/content/dam/digital/carelon/cbh-assets/documents/global/billing-and-claims/tips-for-completing-the-ub04.pdf

[2] TN HDDS Manual — https://www.tn.gov/content/dam/tn/health/documents/HDDSManual11.pdf