Where do you enter the name of the referring physician in the CMS-1500 form?

The name of the referring physician is entered in Block 17 of the CMS-1500 form. This block is specifically designated for the referral information, which typically includes the name of the physician who referred the patient for the services rendered. The inclusion of this information is essential for the insurance claim process, as it provides context for the services provided, ensuring that the claim is processed accurately in relation to the correct physician.

Block 15 is used for the date of the current or most recent visit, Block 16 pertains to the dates of the patient’s illness or injury, and Block 19 is often used for additional information or comments. Each of these blocks serves its own particular purpose, but Block 17 is specifically tailored to capture the name of the referring physician, making it the correct option for this question.