Get the free 837 Professional Transaction Header - okhca

Oklahoma Medicaid Management Information System Interface Specifications 837 Professional Health Care Claim HIPAA Guidelines for Electronic Transactions Companion Document The following is intended

How to fill out 837 professional transaction header

How to fill out 837 professional transaction header:

1. Start by gathering all necessary information such as the provider's name, address, and contact details.
2. Identify the payer's information including their name, address, and contact details.
3. Specify the type of transaction being conducted, whether it is a claim, eligibility inquiry, or a remittance advice.
4. Enter the transaction control number, which is a unique identifier for each transaction.
5. Include the date on which the transaction is being submitted.
6. Provide the billing provider's National Provider Identifier (NPI) and the payer's identification number.
7. Indicate the billing provider's Tax Identification Number (TIN) and the payer's TIN.
8. Include any applicable reference numbers related to this transaction, such as prior authorization or referral numbers.
9. Include any additional information required by the payer, such as the patient's identification number or the service location.
10. Finally, review the completed header section for accuracy before submitting the transaction.

Who needs 837 professional transaction header?

1. Healthcare providers who submit claims to insurance companies or payers require the 837 professional transaction header.
2. Insurance companies or payers use the 837 professional transaction header to process and track claims, eligibility inquiries, or remittance advices.
3. Any entity involved in the electronic exchange of healthcare information, including clearinghouses and billing services, may also require the 837 professional transaction header.

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What is 837 professional transaction header?

The 837 professional transaction header is a segment of an electronic data interchange (EDI) file that contains general control information for healthcare claims. It provides the necessary details for identifying the sender and receiver of the transaction, as well as additional information related to the claims being submitted.

Who is required to file 837 professional transaction header?

Healthcare providers, such as hospitals, physicians, and clinics, are required to file the 837 professional transaction header when submitting electronic healthcare claims to payers, such as insurance companies or government agencies.

How to fill out 837 professional transaction header?

The 837 professional transaction header is typically filled out using specialized healthcare software or systems that support the generation of EDI files. Healthcare providers need to populate the header segment with accurate and complete information, including their own identification, the payer's identification, and relevant transaction codes.

What is the purpose of 837 professional transaction header?

The purpose of the 837 professional transaction header is to facilitate accurate and efficient processing of healthcare claims. It ensures that the claims are properly identified, routed, and processed by providing essential information to the payer, such as the sender and receiver IDs, transaction types, and submission details.

What information must be reported on 837 professional transaction header?

The 837 professional transaction header requires the reporting of various information, including the provider's identification number (e.g., National Provider Identifier), payer's identification number, transaction control number, submission or batch number, and the type of transaction being submitted (e.g., original claim, resubmission, or correction).

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