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837 Professional Claims Standard Companion Guide for Submitters To be used in conjunction with the Implementation Guide and Addenda for ASC X12N 837 Version 004010×098A1 January 2008 MD Online, Inc.

How to fill out 837 professional claims standard

How to fill out 837 professional claims standard:

1. Begin by gathering all necessary patient information, including their full name, date of birth, address, and insurance information.
2. Use a designated software or online platform that supports the creation of 837 professional claims. This will ensure that the format and structure of the claim are compliant with industry standards.
3. Select the appropriate version of the 837 professional claims standard that aligns with your needs. There are several versions available, each accommodating different types of healthcare providers.
4. Enter the required transaction information, such as the claim's unique identifier, submission date, and the name of the provider who is responsible for the claim.
5. Include the relevant diagnosis codes associated with the patient's conditions. These codes should be based on the most recent International Classification of Diseases (ICD) guidelines.
6. Enter the healthcare services provided to the patient, including the date of service, the CPT or HCPCS codes that describe each service, the quantity or duration of the service, and any applicable modifiers.
7. Include the appropriate revenue codes that correspond to the services rendered.
8. If necessary, input any required attachments or supporting documentation, such as medical records or prior authorization forms. Make sure these attachments are securely transmitted along with the claim.
9. Review the completed 837 professional claim for accuracy and completeness. Verify that all information is entered correctly, and confirm that there are no missing or duplicated data elements.
10. Once you are satisfied with the claim, submit it electronically to the appropriate clearinghouse or directly to the payer, depending on the submission process specified by the insurance company.

Who needs 837 professional claims standard?

1. Healthcare providers: Medical practices, hospitals, clinics, laboratories, and other healthcare facilities that bill insurance companies or government payers for medical services provided to patients.
2. Insurance companies: Payers, such as private health insurance companies and government programs like Medicare and Medicaid, that receive and process claims from healthcare providers.
3. Medicare Administrative Contractors (MACs): These are the private companies contracted by the Centers for Medicare & Medicaid Services (CMS) to process Medicare claims. They also require the use of the 837 professional claims standard for electronic claim submissions.

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What is 837 professional claims standard?

837 professional claims standard is a format used for submitting healthcare claims electronically.

Who is required to file 837 professional claims standard?

Healthcare providers, billing services, and clearinghouses are required to file 837 professional claims standard.

How to fill out 837 professional claims standard?

837 professional claims standard is filled out using specific data elements and codes as outlined in the format specifications.

What is the purpose of 837 professional claims standard?

The purpose of 837 professional claims standard is to standardize the electronic submission of healthcare claims for processing and payment.

What information must be reported on 837 professional claims standard?

Information such as patient demographics, diagnosis codes, procedure codes, and billing information must be reported on 837 professional claims standard.