--- title: Box 1 – Insurance Coverage Type description: What Boxes 1 and 1a on the CMS-1500 claim form mean, and how Pabau fills the coverage type and the insured member ID on US insurance claims. --- [Skip to content](https://support.pabau.com/en/pabau2/box-1-insurance-coverage-type#main-content) [![pabau logo white](https://support.pabau.com/hubfs/pabau%20logo%20white.svg)](https://support.pabau.com/en/pabau2?hsLang=en) Open main navigation Close main navigation - [Get Support](https://pabau.com/support-center/) [Get Support](https://pabau.com/support-center/) Pabau Knowledge Base - There are no suggestions because the search field is empty. 1. [Pabau Knowledge Base](https://support.pabau.com/en/pabau2?hsLang=en) 2. [Insurance Billing](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en) 3. [US Insurance Billing Additional Resources](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en#us-insurance-billing-additional-resources) # Box 1 – Insurance Coverage Type On the CMS-1500 claim form, **Box 1** tells the payer what type of health coverage the claim is billed to, and **Box 1a** identifies the insured person's policy with the payer. This guide explains what each box means and where Pabau takes the values from. **NOTE:** This article is part of the *US Insurance Billing Additional Resources* series, which walks through every box of the CMS-1500. If you are new to claims in Pabau, start with [Creating a US Professional (CMS 1500) Claim](https://support.pabau.com/en/pabau2/creating-a-us-professional-cms-1500-claim?hsLang=en). ## Box 1 — Insurance coverage type ![Box 1 of the CMS-1500 claim form with the seven coverage type checkboxes](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/cms1500-box1-form.png) Box 1 carries seven checkboxes — **Medicare**, **Medicaid**, **TRICARE**, **CHAMPVA**, **Group Health Plan**, **FECA Blk Lung**, and **Other** — and exactly one of them is marked to show the program the claim bills to. On a paper claim the box is optional; on an electronic claim the coverage type always travels with the claim. **How Pabau fills it** For **electronic claims**, you never set Box 1 by hand. The claim's payer is the Claim.MD payer linked to your insurer in **Setup \> Claims \> Claim.MD \> Payers**, and it is shown in the Payer tile at the top of the claim. The clearinghouse determines the coverage type from that payer, so picking the right payer is what gets this box right. ![The claim header in Pabau showing the Policy Member ID and Payer tiles](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/cms1500-box1-claim-header-tiles.png) **For printed claims** (Export \> Print CMS-1500 form), Pabau marks the box that matches the insurer's **Insurance program**. Set it once per insurer: **Setup \> Company Accounts**, **Third Parties** tab, click the insurer, then **Settings**. A group health plan ticks Group Health Plan, FECA and Black Lung tick FECA Blk Lung, and Medicare, Medicaid, TRICARE and CHAMPVA programs tick their own boxes. While the program is **Not set**, Pabau falls back to the payer name: a name containing Medicare, Medicaid, TRICARE or CHAMPVA gets that checkbox, and every other payer is marked as Other. **NOTE:** If the printed form ticks **Other** for a payer that wants Group Health Plan or FECA Blk Lung, set that insurer's **Insurance program** and print again. ## Box 1a — Insured's ID number ![Box 1a of the CMS-1500 claim form for the insured's ID number](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/cms1500-box1a-form.png) Box 1a holds the **member or subscriber ID** the payer assigned to the insured person's policy — the number on the front of the insurance card. It is required on every claim, paper or electronic. **How Pabau fills it** The value comes from the **membership number on the client's insurance policy**. You will find it on the client card: open the **Insurance** tab of the left panel to see every policy with its membership number, and use **New Policy** to add one. ![The Insurance tab on the client card listing policies with their membership numbers](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/cms1500-box1a-client-policies.png) When an invoice is issued to the insurer, the policy's membership number flows onto the claim as **Member / policy number** in the claim's Insurance section. It is a required field, and you can correct it on the claim itself before validating or sending. ![The Insurance section of a Pabau claim with the Member / policy number field](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/cms1500-box1a-claim-insurance-section.png) **On the electronic claim:** the member ID is sent to Claim.MD as the subscriber ID, which lands in Loop 2010BA, Segment NM109 of the 837P file; the coverage type from Box 1 corresponds to the claim filing indicator in Segment SBR09. **TIP:** Run an eligibility check from the claim (the Eligibility chip above the Policy Member ID tile) before submitting — it verifies the member ID against the payer and catches typos before they become rejections. See [Request eligibility and benefits report](https://support.pabau.com/en/pabau2/request-eligibility-and-benefits-report?hsLang=en). 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