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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.
What is a 837 - Health Care Claim document?
The 837 EDI document type is an electronic version of a paper Health Care Claim. Standard EDI formats include X12, ANSI, EDIFACT and its subsets. The 837 EDI document type is used to submit health care claim billing information, encounter information, or both, from health care service providers to payers.
What makes up the 837 - Health Care Claim document?
An EDI 837 - Health Care Claim 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 claim number, type of claim, and billing information, identical to a paper health care claim. There are an infinite number of possibilities available for a company to include data on an 837 Health Care Claim. There are an infinite number of possibilities available for a company to include data on an 837 - Health Care Claim.
How is a 837 - Health Care Claim used?
The 837 EDI document is sent by a health care provider to an insurance payer when a claim is made. After the 837 Health Care Claim is received, a 997 Functional Acknowledgment is sent back from the receiver indicating that the 837 Health Care Claim was successfully received.
How is a 837 - Health Care Claim 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.