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This document serves as a companion guide for the ASC X12N Health Care Claim Payment/Advice (835) Transaction Set, detailing the specifications, conventions, and requirements for electronic data interchange
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How to fill out pacificare electronic data interchange
How to fill out PacifiCare Electronic Data Interchange 835 Transaction Companion Guide
01
Obtain the PacifiCare Electronic Data Interchange 835 Transaction Companion Guide from the official PacifiCare website.
02
Review the introduction section to understand the purpose of the 835 transaction.
03
Locate and familiarize yourself with the specific sections that detail data elements and formats.
04
Follow the step-by-step instructions for data input, paying attention to required fields and optional segments.
05
Use the examples provided in the guide to visualize the correct formatting for each field.
06
Cross-check your entries with the guide after filling out the transaction to ensure accuracy.
07
Submit the completed EDI 835 transaction as per the submission protocols outlined in the guide.
Who needs PacifiCare Electronic Data Interchange 835 Transaction Companion Guide?
01
Healthcare providers who submit claims electronically and require payment remittance details.
02
Billing departments within healthcare organizations that need to process and reconcile payment information.
03
Third-party billing services that represent healthcare providers and need to handle EDI transactions.
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People Also Ask about
What is the EDI transaction code 835?
What is EDI 835? EDI 835 is a transaction set for Healthcare Claim Payment and Remittance Advice. Insurance companies use it to communicate payment details to healthcare providers, including information on paid, denied, or adjusted claims, as well as deductibles, co-pays, and co-insurance.
What is claim status code 835?
HIPAA 835: The 835 transaction is a standard transaction mandated by the Health Insurance Portability and Accountability Act (HIPAA) and is used to transfer payment and remittance information for adjudicated professional and institutional health care claims.
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 claim status codes 835?
The 835 Health Care Payment / Advice, also known as the Electronic Remittance Advice (ERA), provides information for the payee regarding claims in their final status, including information about the payee, the payer, the payment amount, and any payment identifying information.
What is the 835 file used for?
The 835 (Health Care Claim Payment/Advice) is part of the ASC X12N 835 standard, which is a HIPAA-compliant electronic transaction format. It provides healthcare providers with essential payment details, including: Payment amounts for claims. Adjustments and denials.
What is the 835 format in medical billing?
The 835 (Health Care Claim Payment/Advice) is part of the ASC X12N 835 standard, which is a HIPAA-compliant electronic transaction format. It provides healthcare providers with essential payment details, including: Payment amounts for claims. Adjustments and denials.
What is the EDI transaction code 835?
What is EDI 835? EDI 835 is a transaction set for Healthcare Claim Payment and Remittance Advice. Insurance companies use it to communicate payment details to healthcare providers, including information on paid, denied, or adjusted claims, as well as deductibles, co-pays, and co-insurance.
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What is PacifiCare Electronic Data Interchange 835 Transaction Companion Guide?
The PacifiCare Electronic Data Interchange 835 Transaction Companion Guide is a document that outlines the specifications and requirements for the electronic exchange of healthcare payment and remittance advice information using the ANSI X12 835 transaction set.
Who is required to file PacifiCare Electronic Data Interchange 835 Transaction Companion Guide?
Providers, payers, and any healthcare organizations that engage in electronic billing and payment processing with PacifiCare are required to file the PacifiCare Electronic Data Interchange 835 Transaction Companion Guide.
How to fill out PacifiCare Electronic Data Interchange 835 Transaction Companion Guide?
To fill out the guide, users should follow the detailed instructions provided in the companion guide, including adhering to specific formatting, data element requirements, and follow the outlined submission procedures to ensure compliance with PacifiCare's standards.
What is the purpose of PacifiCare Electronic Data Interchange 835 Transaction Companion Guide?
The purpose of the guide is to facilitate the accurate and efficient electronic exchange of remittance data, improve the claims reconciliation process, and provide clear instructions for compliance with PacifiCare's electronic transaction requirements.
What information must be reported on PacifiCare Electronic Data Interchange 835 Transaction Companion Guide?
The information reported must include payment amounts, adjustments, claim identifiers, patient details, service dates, and any other necessary data as specified in the guide that is crucial for payment reconciliation and accounting.
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