Block 11c for non-Medicare payers requires what action?

• A. Enter a 'x' in the correct box
• B. Enter the full payer name
• C. Enter the effective date
• D. Leave blank

Answer: (A)

Block 11c uses a simple checkbox to indicate payer status. When the payer isn’t Medicare, you mark the correct box with an X to show that another payer is involved and that coordination of benefits is needed. This is not a place to write the payer’s name or an effective date; those details go in other fields. Leaving it blank or filling in those other details in this box wouldn’t communicate the required status and could delay processing.