Insured's name. This information comes from the Case window, Policy 1, 2 or 3 tab, Policyholder field. If Medicare is the primary destination carrier, this box is left blank. If there is insurance primary to Medicare, the name of the insured is printed here. When the insured and the patient are the same, the word "SAME" or duplicate information is printed here. If the Insurance Type of the destination payer is Worker's compensation, print the Patient Case Employer Name. Note: if the insured's name has a space in it (for example VAN DYKE), the CMS-1500 form will strip the space and claims may be rejected. You can fix this by changing the field that is used for this box using Reports Designer. In Report Designer, select the Claim report and use the Full Name LFM field for Box 4, instead of Full Name LFM w Comma.