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This document serves as a guide for implementing the X12 837I transaction for institutional claims under HIPAA regulations, detailing segment usage and providing implementation guidelines.
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How to fill out companion guide x12 837i
How to fill out Companion Guide X12 837I
01
Obtain the latest version of the Companion Guide X12 837I.
02
Review the general instructions provided in the guide.
03
Identify the required fields: These include the patient information, provider details, and service line items.
04
Fill in the patient information accurately, including demographics and insurance details.
05
Enter provider information, including NPI and organization identifiers.
06
List each service provided with corresponding CPT/HCPCS codes, quantities, and charges.
07
Ensure the correct use of modifiers where applicable.
08
Validate the data against the guidelines to avoid errors.
09
Submit the completed X12 837I file to the appropriate payer.
Who needs Companion Guide X12 837I?
01
Healthcare providers submitting claims for institutional services.
02
Billing offices and claims processors.
03
Insurance payers analyzing claims data.
04
Software developers creating applications that handle healthcare claims.
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People Also Ask about
What is the X12 837 standard?
Claims submission: The X12-837 HIPAA format is used when a physician or other health care provider (e.g. hospital) files an electronic claim for payment for the delivery of care. This format is similar in many respects to the UB-92 and the HCFA-1500 formats.
What is ANSI ASC X12N 837I used for?
The ASC X12N 837 (04010X096A1) is the standardized electronic format mandated by HIPAA-mandated transactions for submitting institutional claims or encounter data. This form is used for institutional claims from hospitals, skilled nursing facilities, and home health agencies.
What is the difference between 837I and 837P?
Companion Guides are designed to reinforce online course material, helping students focus on important concepts and organize their study time for quizzes and exams.
What is the primary purpose of the EDI 837?
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.
What is an EDI companion guide?
Our Electronic Data Interchange (EDI) Companion Guides describe specific requirements for trading partners who exchange electronic transactions directly with Blue Shield of California Promise Health Plan (not through a vendor or clearinghouse).
What is ANSI ASC X12N 837?
The ASC X12 837 Health Care Claim: Professional and associated addenda define the transaction for electronically transmitting professional claims or equivalent encounters, including coordination of benefits information in ance with the Health Insurance Portability and Accountability Act (HIPAA).
What is 837I used for?
The 837I is the standard format institutional providers use to submit health care claims electronically.
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What is Companion Guide X12 837I?
The Companion Guide X12 837I is a document that provides specific instructions and clarifications on how to complete the X12 837 Institutional claim transaction for healthcare services. It serves as a bridge between the technical specifications of the X12 standard and the specific implementation requirements for a particular payer or provider.
Who is required to file Companion Guide X12 837I?
Healthcare providers and institutions that submit electronic claims for institutional services to health plans or payers are required to use the Companion Guide X12 837I to ensure compliance with specific payer guidelines.
How to fill out Companion Guide X12 837I?
To fill out the Companion Guide X12 837I, providers should follow the detailed instructions provided in the guide, adhere to the X12 transaction set standards, and utilize any specific requirements or codes outlined for the intended payer. This includes accurately entering patient, provider, and claim information as specified.
What is the purpose of Companion Guide X12 837I?
The purpose of the Companion Guide X12 837I is to provide a detailed framework that assist healthcare providers in understanding and executing the requirements for submitting electronic institutional claims, thereby facilitating smoother claims processing and better communication between providers and payers.
What information must be reported on Companion Guide X12 837I?
The information that must be reported on the Companion Guide X12 837I includes patient demographics, claim details, provider information, service codes, diagnosis codes, and any necessary attachments as per the payer's requirements. This may also include additional documentation requested by the payer.
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