Get the free 837 Health Care Claim Professional Companion Guide HIPAA

Blue Cross & Blue Shield of Rhode Island 837 Health Care Claim: Professional Companion Guide HIPAA version 5010 Version 1.2 Status: Published March 2, 2012, Blue Cross & Blue Shield of Rhode Island

How to fill out 837 health care claim

How to fill out 837 health care claim:

1. Gather necessary information: Before starting to fill out the 837 health care claim, collect all the relevant information such as the patient's personal details, insurance information, medical codes, and any supporting documentation.
2. Begin with the Patient Information: Start by entering the patient's full name, address, date of birth, and any other required demographic information. This ensures that the claim is correctly associated with the patient.
3. Provide Insurance Details: Enter the insurance policy information, including the policyholder's name, policy number, and any other necessary details. It is important to accurately include all insurance-related information to facilitate a smooth claims process.
4. Enter Diagnosis and Procedure Codes: Use the appropriate medical coding system (such as ICD-10 and CPT codes) to accurately describe the patient's diagnosis and the provided medical procedures. These codes help in proper billing and documenting the medical services rendered.
5. Include Date and Description of Services: For each medical service or procedure, enter the date it was performed, the description of the service provided, and any additional relevant details. This helps provide a comprehensive overview of the treatment received by the patient.
6. Document Charges and Payments: Specify the charges for each service or procedure performed, and indicate any payments received from the patient or insurance company. It is crucial to accurately record this information to ensure proper payment processing.
7. Attach Supporting Documentation: If required, attach any supporting documentation, such as medical reports, test results, or referrals that provide additional context or justification for the services provided.

Who needs 837 health care claim:

1. Healthcare Providers: Healthcare providers, including doctors, hospitals, clinics, and other medical professionals, need to submit an 837 health care claim to request reimbursement for the services they have provided to patients covered by insurance.
2. Insurance Companies: Insurance companies require the submission of 837 health care claims to process and review the services provided to their policyholders. These claims assist in determining the coverage, eligibility, and payment to healthcare providers.
3. Patients: Patients also benefit from knowing about the 837 health care claim as it helps them understand the billing and reimbursement process. They may need to review the claim details for accuracy and ensure that their insurance coverage has been appropriately applied.

In summary, filling out the 837 health care claim involves gathering necessary information, providing patient and insurance details, accurately coding diagnoses and procedures, documenting services, charges, and payments, and attaching any required supporting documentation. Healthcare providers, insurance companies, and patients are the key entities that require knowledge and involvement in the 837 health care claim process.

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