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Revision: April 5, 2012837 Health Care Claim:Dental ASC X12N 837D (Version 005010A2)Companion Guide Inflatable of Contents1.0 Introduction×3 1.1 What Is HIPAA? 3 1.2 Purpose of the Implementation
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Obtain the ASC X12N 837D version form
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Read the instructions carefully to understand the requirements
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Provide the necessary patient information, including name, address, and insurance details
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Indicate the appropriate diagnosis codes and procedure codes for the services provided
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Enter the billed amounts for each service rendered
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Include any supporting documentation required
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Double-check the completed form for accuracy and completeness
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Submit the filled-out ASC X12N 837D version form to the appropriate entity

Who needs asc x12n 837d version?

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Healthcare providers such as doctors, dentists, hospitals, and clinics
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Health insurance companies
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Pharmacies

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ASC X12N 837D version is a specific format for healthcare claim transactions, most commonly used for dental claims.
Healthcare providers, dental offices, and other entities involved in dental claim submissions are required to file ASC X12N 837D version.
ASC X12N 837D version can be filled out using electronic data interchange (EDI) software that supports the format. Each section of the claim form must be completed accurately.
The purpose of ASC X12N 837D version is to standardize the electronic submission of dental claims for efficient processing by insurance companies.
ASC X12N 837D version requires information such as patient demographics, procedure codes, diagnosis codes, provider information, and insurance details.
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