The EDI 837 is a type of electronic data interchange transaction set that is used in healthcare for submitting claims for medical, dental, and institutional services. It is commonly used by healthcare providers to submit claims to payers (like insurance companies) to request reimbursement for the services provided to patients. This format adheres to HIPAA (Health Insurance Portability and Accountability Act) standards, which makes it secure and efficient for handling sensitive patient data.
This electronic document complies with the ANSI X12 EDI specification.
All EDI documents are securely encrypted in transit, allowing trading partners to send sensitive data safely.
Security
HIPAA-compliant EDI transactions offer secure handling of sensitive health information, reducing the risk of unauthorized access.
Cost Savings
Automated processing of EDI claims reduces administrative costs for both providers and payers by eliminating paper, postage, and manual work.
The EDI 837 is designed specifically for healthcare claims. It includes detailed information about the patient, provider, services rendered, diagnosis codes, and costs. EDI 837 claims fall into three categories:
Each segment and data element in the EDI 837 transaction set serves a specific purpose to ensure that claims are submitted accurately and completely for processing.
EDI 837 is structured around a set of standard segments and elements defined by the American National Standards Institute (ANSI) X12 format. The specifications ensure consistent and efficient exchange of information between trading partners across various industries.
The EDI 837 is utilized by healthcare organizations and medical providers to communicate healthcare claims.
HIPAA-compliant EDI transactions offer secure handling of sensitive health information, reducing the risk of unauthorized access.
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