In Block 4, if the patient and the insured are the same, what should be written?

In Block 4 of the CMS-1500 form, if the patient and the insured are the same individual, "SAME" should be written. This is crucial because it clearly indicates to the insurance company that the patient who is receiving the medical services is also the person who holds the insurance policy. This information helps streamline the claims processing, as it establishes a direct link between the patient’s identity and their coverage, ensuring that there are no discrepancies in billing and that the claim can be processed efficiently.

Using "SAME" eliminates potential confusion that could arise if different terms were used, such as “DIFFERENT,” which would imply that there are two separate entities involved, or “UNKNOWN,” which suggests a lack of clarity about the relationship, complicating the claims process. Likewise, "NOT APPLICABLE" would be inappropriate in this situation, as it fails to provide the necessary information about the relationship between the patient and the insured.