Get the free 837 Health Care Claim Companion Guide: Dental
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837 Health Care Claim
Companion Guide:
Dental
HIPAA 005010×224A2
Version: 3.5 Final
Company: Delta Dental of California
Publication: 9/4/2014Table of Contents
Introduction..........................................................................................................................................
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How to fill out 837 health care claim
How to fill out 837 health care claim
01
To fill out a 837 health care claim form, follow these steps:
02
Begin by providing your personal information such as your name, address, and contact details.
03
Specify the necessary provider information, including the name and address of the healthcare facility.
04
Include the patient's details, such as their name, date of birth, gender, and insurance ID number.
05
Clearly state the medical service or procedure being claimed, along with the corresponding diagnosis codes.
06
Provide the dates of service and the total charges for each service or procedure.
07
Indicate the payment responsibility, whether it is the patient, insurance company, or other third party.
08
If there are any supporting documents or attachments required, make sure to include them with the claim form.
09
Review the completed form for accuracy and completeness before submitting it to the relevant entity.
10
Submit the filled-out 837 health care claim form to the appropriate insurance company or payer for processing.
11
Keep a copy of the submitted form and any supporting documentation for your records.
Who needs 837 health care claim?
01
Various stakeholders in the healthcare industry may need to use the 837 health care claim form, including:
02
- Healthcare providers who offer and bill for medical services
03
- Medical billing and coding professionals who handle claims on behalf of healthcare providers
04
- Insurance companies or payers responsible for processing and reimbursing healthcare claims
05
- Government agencies that require insurance claims data for statistical analysis or regulatory purposes
06
- Patients who need to submit claims for reimbursement or to provide documentation of medical expenses
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What is 837 health care claim?
837 health care claim is a standard electronic format used for submitting healthcare claim forms to payers such as insurance companies.
Who is required to file 837 health care claim?
Healthcare providers and institutions, such as hospitals and clinics, are required to file 837 health care claim forms.
How to fill out 837 health care claim?
837 health care claim forms can be filled out electronically using specialized software or manually using paper forms.
What is the purpose of 837 health care claim?
The purpose of 837 health care claim is to request payment from insurance companies for healthcare services provided.
What information must be reported on 837 health care claim?
Information such as patient demographics, insurance information, diagnosis codes, procedure codes, and billed amounts must be reported on 837 health care claim.
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