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The 837 file includes insurance claim data. The complication is that 837 files may contain not just one claim but multiple from the hospital to the payer. The 837s will include information that details aspects of patients treatment, including medical services provided, cost of treatment, and additional adjustments.
Professional Paper Claim Form (CMS-1500) | CMS.
The 837 File. So, what is an 837 file? Basically, its an electronic file that contains information about a patient claims. This form is submitted to a clearinghouse or insurance company instead of a paper claim.
The 837P (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. The Form CMS-1500 is the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed.
Step 1: Collect Your Itemized Receipts To file a claim you need to first obtain an itemized bill from your doctor or medical provider. This bill will list every service you received along with the cost and a special code the insurance company will need to pay your claim.
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What is an 837 File? An 837 file is an electronic file that contains patient claim information. This file is submitted to an insurance company or to a clearinghouse instead of printing and mailing a paper claim.
Under the EDI 837 standard, the PPI format includes the following information. Description of the patient. Condition for which the patient was treated. Nature of service provided. Total cost of the treatment.
The 837P (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. The Form CMS-1500 is the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed.
About the X12 837 and 835 file Formats The X12 837 and 835 files are industry standard files used for the electronic submission of healthcare claim and payment information. The 837 files contain claim information and are sent by healthcare providers (doctors, hospitals, etc) to payors (health insurance companies).
An 837 file is an electronic file that contains patient claim information. This file is submitted to an insurance company or to a clearinghouse instead of printing and mailing a paper claim.

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