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What is an 837 claim?

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. The data in an 837 file is called a Transaction Set.

What is the difference between companion guide and implementation guide?

Companion Guides are intended to supplement rather than replace the standard Implementation Guide for each transaction set. The information in these documents is not intended to: Modify the definition, data condition, or use of any data element or segment in the standard Implementation Guides.

What is an 837 institutional claim?

The 837I (Institutional) is the standard format institutional providers use to send health care claims electronically. Review the chart below for more information about the American National Standards Institute (ANSI) Accredited Standards Committee (ASC) X12N 837I claim format.

What is the EDI 837 specification?

EDI 837 Specification This transaction set can be used to submit healthcare medical claims, billing information, encounter information, or both, from providers of healthcare services to payers, either directly or via intermediary billers and claims clearinghouses.

What is an example of an institutional claim?

Hospital stays, emergency department visits, operations, diagnostic testing, and other services are all examples of institutional claims.

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