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MMS Replacement Project (MRP)Health Care Claim Institutional (837) Transaction Standard Companion Guide Companion to Health Care Claim ASC X12N 837 005010×223 Implementation Guide September 2022

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01

Obtain the necessary software that supports the institutional 837 transaction standard.

02

Identify the specific data required to complete the transaction, such as patient information, provider details, and service codes.

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Enter the data into the appropriate fields in the software, ensuring accuracy and compliance with the standard.

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Validate the completed transaction to check for any errors or missing information.

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Submit the institutional 837 transaction to the designated recipient for processing and payment.

Who needs institutional 837 transaction standard?

01

Healthcare providers who bill for institutional services, such as hospitals, outpatient facilities, and other healthcare organizations.

02

Health insurance companies or third-party payers who process claims for institutional services.

03

Government agencies or regulatory bodies that oversee healthcare billing and reimbursement.

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What is institutional 837 transaction standard?

Institutional 837 transaction standard is a set of electronic data interchange (EDI) format used for submitting healthcare claims for institutional services such as hospitals, clinics, and nursing homes.

Who is required to file institutional 837 transaction standard?

Healthcare providers and institutions that provide institutional services are required to file institutional 837 transaction standard.

How to fill out institutional 837 transaction standard?

Institutional 837 transaction standard can be filled out using specific EDI software or through a clearinghouse that specializes in healthcare claims.

What is the purpose of institutional 837 transaction standard?

The purpose of institutional 837 transaction standard is to streamline the billing process for healthcare providers and institutions by using a standardized format for submitting claims.

What information must be reported on institutional 837 transaction standard?

Information such as patient demographics, diagnosis codes, procedure codes, and insurance information must be reported on institutional 837 transaction standard.

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