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Below you will essential information in regards to this EDI. If you have any specific questions about integrating your EDI with your ERP and eCommerce please reach out. Take advantage of our "start planning" feature to map out your integration needs. 

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What is a 835 - Health Care Claim Payment/Advice document?

The 835 EDI document type is an electronic version of a paper Health Care Claim Payment/Advice. Standard EDI formats include X12, ANSI, EDIFACT and its subsets. The 835 EDI document type is used to make a payment or send an explanation of benefits from a health care insurer to a health care provider.

What makes up the 835 - Health Care Claim Payment/Advice document?

An EDI 835 - Health Care Claim Payment/Advice document is organized into segment and data elements. A segment can contain at least one data element. Each data element contains a data field. Data elements can include date, amount paid, and explanation, identical to a paper health care claim payment. There are an infinite number of possibilities available for a company to include data on an 835 Health Care Claim Payment/Advice. There are an infinite number of possibilities available for a company to include data on an 835 - Health Care Claim Payment/Advice.

How is a 835 - Health Care Claim Payment/Advice used?

The 835 EDI document is sent from a health care insurer to a health care provider either to make a payment or to send an Explanation of Benefits remittance advice. It is sent either directly or through a financial institution. After the 835 Health Care Claim Payment/Advice is received, a 997 Functional Acknowledgment is sent back indicating that the 835 Health Care Claim Payment/Advice was successfully received.

How is a 835 - Health Care Claim Payment/Advice processed?

An EDI solution is required to process the EDI documents received into an ERP or accounting system or into a readable format for manual entry. Each trading partner will have an EDI Implementation guide outlining the specific segments, data elements, values accepted, and the applicable business rules to be followed.

eBridge Connections has pre-built maps for all EDI transaction documents including 850 purchase orders, 810 invoices, and 856 advance shipping notices.