EDI Standards for sending elecontric claims

[SolutionMakers]

Greetings:

I'm hoping someone can point me to some definitive examples of the data that needs to be transferred when submitted e-claims for payment? I've searched sites for ANSI X12N-837 Professional Claims, but have not found the exact data.

Tia,

Laura

[Brian C]

For the 837 specs, check out this site:

http://www.adminastar.com/Providers/EDI/Intermediary/Specifications/Specifications.html

There is a link there to a pdf file about the 4th link down.

Here you will find a .SEF sample file for the 837 format:

http://www.edidev.com/edidev_hipaa_support.htm

This should give you a good place to start.

[JerrySalem]

Brian,

thanks for the helpfull links.

I never saw a SEF file before. who uses them? It looks sigificantly different from all of the other 837 examples I have seen before.

For example the data seperator is typically an asterisk. (as in the adminastar.com link) but on the sef file example the data seperator is a comma.

TIA

Jerry

[xoomaster]

Hey guys, I am very new to the electronic claims. Any pointers for a newbie ?

I use FMP7 and attempting to implement E-claims through it.

Xoomaster

[ffar]

Here's a link to the site housing every HIPAA standard under the sun: http://www.wpc-edi.com/hipaa, most of which can be downloaded free.