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This document serves as a companion guide for the usage of the X12 V4010X097A1 837 Dental HIPAA Implementation for electronic submitters in the LA Medicaid program, detailing the structure and requirements
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How to fill out health care claim dental
How to fill out Health Care Claim: Dental - 837
01
Obtain the Health Care Claim: Dental - 837 form from your insurance provider or through your dental practice.
02
Fill in the provider's information, including name, address, and National Provider Identifier (NPI).
03
Enter the patient's information, including name, date of birth, and insurance member ID.
04
Provide the dental procedure codes performed, along with the corresponding descriptions and dates of service.
05
Include the diagnosis codes related to the treatment provided.
06
Specify the total charges for each procedure and any insurance payments already received.
07
Sign and date the form to certify that the information provided is accurate and complete.
08
Submit the claim electronically or via mail to the appropriate insurance company address.
Who needs Health Care Claim: Dental - 837?
01
Patients receiving dental care who want to seek reimbursement from their insurance provider.
02
Dental providers submitting claims on behalf of patients to receive payment for services rendered.
03
Insurance companies that require detailed information to process dental claims.
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People Also Ask about
What is the 837I format?
The 837I is the standard format institutional providers use to submit health care claims electronically. Institutional providers include: ANSI ASC X12N 837I.
What is a 837 claim transaction?
An 837 file is an electronic file that contains patient claim information. This file is submitted to an insurance company or to a clearinghouse instead of printing and mailing a paper claim. The data in an 837 file is called a Transaction Set.
What is an 837D file?
• An 837 file is an electronic file that contains patient claim information. This file is submitted to an insurance company or to a clearinghouse instead of printing and mailing a paper claim. • The data in an 837 file is called a Transaction Set.
What are EDI transactions in healthcare?
EDI is the automated transfer of data in a specific format following specific data content rules between a health care provider and Medicare, or between Medicare and another health care plan.
What is the EDI 837 in medical billing?
The EDI 837 transaction set is the format established to meet HIPAA requirements for the electronic submission of healthcare claim information. The claim information included amounts to the following, for a single care encounter between patient and provider: A description of the patient.
What is the electronic format supported for health care claims transactions?
837 Transaction: A type of EDI format used to submit healthcare claim billing information.
What is the EDI 837 healthcare claim transaction?
What is an EDI 837 Healthcare Claim? The EDI 837 Healthcare Claim transaction set is used to submit healthcare medical claims, encounter information, billing information or both, from healthcare services providers to payers. This can be done directly or via intermediary billers and claims clearinghouses.
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What is Health Care Claim: Dental - 837?
Health Care Claim: Dental - 837 is a standardized electronic format used for submitting dental claims to insurance carriers or payers. It allows dental providers to report necessary information regarding services rendered to patients.
Who is required to file Health Care Claim: Dental - 837?
Dental providers, including dentists and dental clinics, are required to file Health Care Claim: Dental - 837 when submitting claims for reimbursement to insurance companies or government programs for dental services provided to patients.
How to fill out Health Care Claim: Dental - 837?
To fill out the Health Care Claim: Dental - 837, providers must input relevant patient information, dental procedure codes (such as CDT codes), dates of service, provider details, and any necessary diagnosis codes into the specified fields of the electronic claim form.
What is the purpose of Health Care Claim: Dental - 837?
The purpose of Health Care Claim: Dental - 837 is to facilitate the electronic submission of dental claims, streamline the claims processing workflow, reduce paperwork, and ensure accurate and timely reimbursement for dental services provided.
What information must be reported on Health Care Claim: Dental - 837?
The information that must be reported on Health Care Claim: Dental - 837 includes patient demographic details, provider information, procedure codes, dates of service, diagnosis codes, and any applicable modifiers for procedures performed.
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