837p claim form example 2025

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The 837P is the standard format health care professionals and suppliers use to submit health care claims electronically. Professional providers include: ANSI ASC X12N 837P.
The EDI 837 transaction set is the format established to meet HIPAA requirements for the electronic submission of healthcare claim information. The claim information included amounts to the following, for a single care encounter between patient and provider: A description of the patient.
In summary, the 835 transaction deals with payment and remittance advice from payers to providers, while the 837 transaction deals with the submission of healthcare claims from providers to payers. They serve different purposes in the healthcare billing and reimbursement process.
An EDI 837 file is a standardized electronic format used for submitting healthcare claims to insurance providers and government agencies. It ensures accurate and efficient transmission of patient care, procedures, and cost details for processing and reimbursement.
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.
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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.
EDI 837P (Professional): Used by individual healthcare providers such as doctors and therapists. EDI 837I (Institutional): Used by hospitals and other healthcare facilities.

837p claim form example