UB-04 Field 60: Insured's Unique ID

Overview

Field 60 on the UB-04 claim form, designated as the Insured’s Unique ID, is a mandatory data element for both inpatient and outpatient hospital billing ^[1]. This field is used to identify the specific identification number assigned to the insured individual by the health insurance payer ^[1]. In the context of Maryland Medicaid, this field is critical for ensuring that the services rendered are correctly attributed to the beneficiary's specific account within the state's reimbursement system ^[1]. The field is positioned on the form following Field 58 (Insured’s Name) and Field 59 (Patient Relationship to Insured), and it precedes Field 61 (Insured’s Group Name) ^[1].

The Insured’s Unique ID serves as the primary link between the provider's claim and the payer's eligibility records ^[1]. The information entered here must exactly match the identification number found on the patient’s insurance card or the most current eligibility verification response ^[1].

When to Use

Field 60 must be used for every claim submission where a third-party payer, such as Medicaid, is being billed for hospital services ^[1]. According to the Maryland Medicaid hospital billing instructions, this field is a required component of the claim regardless of whether the patient is receiving acute inpatient care or outpatient services ^[1]. It is used specifically to report the unique identification number of the person who holds the insurance policy ^[1]. If the patient is the policyholder, their own ID is used; if the patient is a dependent, the ID of the primary insured person must be recorded here ^[1].

In multi-payer scenarios, such as when a patient has both Medicare and Medicaid, Field 60 is used in conjunction with the payer sequence identified in Field 50 ^[1]. The provider must ensure that the ID number placed in the row corresponding to the specific payer is the correct identifier for that specific health plan ^[1]. For Maryland Medicaid claims, this involves entering the recipient's unique Medicaid identification number to facilitate the adjudication of the claim against the state's fiscal intermediary records ^[1].

Step-by-Step Claim Example

To complete Field 60 correctly for a Maryland Medicaid claim, the biller should follow these steps based on the standard UB-04 layout and state-specific requirements:

1. Identify the Payer: Determine the primary payer and list them in Field 50 (Payer Name) ^[1].
2. Verify the Insured: Locate the name of the insured party in Field 58 and their relationship to the patient in Field 59 ^[1].
3. Locate the ID Number: Obtain the unique identification number from the patient's Medicaid card or the electronic eligibility verification system ^[1].
4. Enter the ID in Field 60: On the row corresponding to the payer listed in Field 50, enter the Insured’s Unique ID ^[1]. For example, if Maryland Medicaid is the primary payer on Line A, the Medicaid ID must be entered in Box 60A ^[1].
5. Review for Accuracy: Ensure that no spaces or hyphens are included unless specifically required by the payer's format, and confirm the ID matches the name provided in Field 58 ^[1].
6. Proceed to Group Information: Once Field 60 is populated, the biller moves to Field 61 (Insured’s Group Name) and Field 62 (Insured’s Group Number) if applicable ^[1].

Common Mistakes & Audit Red Flags

Another common mistake is a mismatch between the ID number in Field 60 and the Insured’s Name in Field 58 ^[1]. If the ID belongs to a parent but the name in Field 58 is the child's, the claim will be flagged for inconsistent data ^[1].

Inaccurate transcription of the ID number—such as swapping the letter "O" for the number "0"—is a leading cause of claim rejection ^[1]. Additionally, failing to update the ID number after a patient has received a new card or changed coverage plans can lead to "Member Not Found" errors ^[1]. Auditors often look for patterns where Field 60 is left blank on secondary or tertiary claims, as the field remains "Required" for all payers listed on the UB-04 form to ensure proper coordination of benefits ^[1].

Related Codes/Fields

Field	Title	Description
FL 50	Payer Name	Identifies the health plan or program from which the provider is seeking reimbursement [1].
FL 58	Insured’s Name	The name of the individual who holds the insurance policy [1].
FL 59	Patient Relationship to Insured	A code indicating how the patient is related to the policyholder [1].
FL 61	Insured’s Group Name	The name of the group or plan through which the insurance is provided [1].
FL 62	Insured’s Group Number	The identification number assigned to the group or employer [1].

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References

[1] Maryland Medicaid — FL 60 — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf