Which Form Locator is the Assignment of Benefit Certification and Required?

Which Form Locator is the Assignment of Benefit Certification and Required?

• A. Form Locator 54 - Prior Payments - Required
• B. Form Locator 55 - Estimated Amount Due - Required
• C. Form Locator 56 - NPI - Required
• D. Form Locator 53 - Assignment of Benefit Certification - Required

Answer: (D)

Assignment of Benefit Certification is the authorization that allows benefits to be paid to the provider rather than to the patient. On the UB-04 form, the field reserved for this certification is the one you complete when a patient assigns their rights to receive payment. That field is required to ensure the payer knows who is entitled to receive the funds and to prevent delays or misdirected payments when the claim is processed. The other fields mentioned serve different purposes: prior payments track money already paid, estimated amount due shows what is expected to be charged or paid, and the NPI identifies the provider. They do not indicate assignment of benefits, so the field for Assignment of Benefit Certification is the correct and necessary one to complete.

Assignment of Benefit Certification is the authorization that allows benefits to be paid to the provider rather than to the patient. On the UB-04 form, the field reserved for this certification is the one you complete when a patient assigns their rights to receive payment. That field is required to ensure the payer knows who is entitled to receive the funds and to prevent delays or misdirected payments when the claim is processed. The other fields mentioned serve different purposes: prior payments track money already paid, estimated amount due shows what is expected to be charged or paid, and the NPI identifies the provider. They do not indicate assignment of benefits, so the field for Assignment of Benefit Certification is the correct and necessary one to complete.