In what scenario would Box 12 be utilized on the CMS-1500?

Box 12 on the CMS-1500 is specifically utilized to show the patient's signature authorization for the release of information. This box typically contains the statement indicating that the provider has the patient’s consent to disclose their health information to the necessary parties involved in the billing process, as stipulated by regulations. This authorization is crucial for compliance with HIPAA (Health Insurance Portability and Accountability Act) and facilitates the processing of claims by insurance companies by ensuring that the patient has agreed to the sharing of their medical information.

The other options do not align with the purpose of Box 12. Indicating total charges for the visit is reflected differently within the form and is usually documented in other specified sections. Listing the referring physician details is assigned to a different box (Box 17). Similarly, the patient's insurance policy number is recorded in the designated field for insurance details and not in Box 12. Therefore, option B correctly identifies the function of Box 12 as it relates specifically to patient consent for information release.