What information is required in Block 5 of the CMS-1500 form?

Block 5 of the CMS-1500 form is specifically designed to capture the relationship of the insured individual to the patient. In the context of health insurance claims, it is crucial to identify whether the patient is the policyholder, spouse, dependent, or has another connection to the policy to ensure accurate billing and processing of the claim. This relationship plays a significant role in determining eligibility for coverage and the correct party responsible for payment.

In contrast, the other options pertain to different details that are necessary for a complete claim but belong to different blocks on the form. For instance, the patient's mailing address and telephone number is found in Block 3, while the patient's insurance policy number is typically recorded in Block 1a. Medical condition details are documented in the designated sections for diagnosis codes. Therefore, understanding the correct content for each block is essential for competent completion of the CMS-1500 form.