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COMMONWEALTH OF VIRGINIAMedicaid Enterprise System (MES) MMS Companion Guide Health Care Claim: Dental (837) ASC X12N 837 VERSION 005010×224A2 January 25, 2022, Document Version 1.4Department of

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01

Gather all necessary information for the EDI 837D companion form, including patient demographics, insurance information, rendering provider information, and service line details.

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Add each service line by specifying the service code, date of service, unit of measurement, and charges for the services provided.

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Who needs mes edi 837d companion?

01

Healthcare providers who are submitting claims for dental services performed for Medicaid beneficiaries in the state of Michigan may need MES EDI 837D companion form.

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Billing entities or clearinghouses handling dental claims on behalf of healthcare providers may also require the MES EDI 837D companion form for electronic submission.

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What is mes edi 837d companion?

MES EDI 837D companion is a specific type of electronic data interchange (EDI) transaction used in healthcare for submitting dental claims to insurance carriers.

Who is required to file mes edi 837d companion?

Dentists and dental offices are required to file MES EDI 837D companion when submitting dental claims to insurance carriers in a standardized electronic format.

How to fill out mes edi 837d companion?

MES EDI 837D companion can be filled out using specialized software or tools that support the ANSI ASC X12 format. Information such as patient demographics, procedures performed, and billing codes must be included.

What is the purpose of mes edi 837d companion?

The purpose of MES EDI 837D companion is to streamline the process of submitting dental claims to insurance carriers, reducing manual data entry errors and processing times.

What information must be reported on mes edi 837d companion?

Information such as patient demographics, provider information, procedures performed, diagnosis codes, and billing codes must be reported on MES EDI 837D companion.

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