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This document serves as a companion guide to facilitate the implementation and compliance of electronic remittance advice transactions (835) through Blue Shield of California's EDI system, ensuring
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How to fill out 835 companion guide
How to fill out 835 Companion Guide
01
Obtain the 835 Companion Guide document specific to your trading partner.
02
Review the sections outlining the structure of the 835 transaction.
03
Identify the required fields as specified in the guide.
04
Ensure that you understand the coding and terminology used in the guide.
05
Complete the 835 transaction data in accordance with the specifications outlined.
06
Validate the completed 835 against the Companion Guide to ensure compliance.
07
Submit the 835 transaction following your organization's submission procedures.
Who needs 835 Companion Guide?
01
Healthcare providers who receive payment for services rendered.
02
Billing departments that process electronic remittance advice.
03
Payers and insurance companies that need to communicate payment details.
04
Any organization engaged in electronic claims processing and remittance.
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People Also Ask about
What is the 835 format in medical billing?
The EDI 835 Claim Payment/Advice is used to make and detail payments to healthcare providers and/or provide Explanations of Benefits (EOBs). Providers or third-party services send the EDI 837 Healthcare Claim to payers. The optional EDI 275 Additional Patient Information (Unsolicited) may also be sent with attachments.
What is the 835 format for healthcare?
An electronic Explanation of Benefits (EOB), also known as Electronic Remittance Advice (ERA), or Electronic Data Interchange (EDI) 835 file, is a digital version of a paper EOB for an insurance claim payment. It includes details such as: Amounts paid. Reasons for denials or adjustments.
What is the United Healthcare Companion Guide?
The UnitedHealthcare Companion Guide identifies key data elements from the transaction set that will be provided in the transaction. The recommendations made are to enable you to more effectively complete EDI transactions with UnitedHealthcare.
Is an 835 the same as an EOB?
An electronic Explanation of Benefits (EOB), also known as Electronic Remittance Advice (ERA), or Electronic Data Interchange (EDI) 835 file, is a digital version of a paper EOB for an insurance claim payment. It includes details such as: Amounts paid. Reasons for denials or adjustments.
What is the 835 file format?
In other words, an 837 is a bill and an 835 is a receipt. Sometimes 835 claims are also called Electronic Remittance Advice (ERA). Similar to 837s, they provide information about the rendered healthcare services. This includes data points such as…
What is an EDI companion guide?
Our Electronic Data Interchange (EDI) Companion Guides describe specific requirements for trading partners who exchange electronic transactions directly with Blue Shield of California Promise Health Plan (not through a vendor or clearinghouse).
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What is 835 Companion Guide?
The 835 Companion Guide is a document that provides detailed instructions and specifications for the implementation of the ANSI X12 835 format, which is used for healthcare claims payment and remittance advice.
Who is required to file 835 Companion Guide?
Healthcare payers and providers who process electronic remittance advice transactions are required to file the 835 Companion Guide to ensure compliance with regulatory standards and to facilitate proper claims processing.
How to fill out 835 Companion Guide?
Filling out the 835 Companion Guide involves following the templates and instructions provided, ensuring all required segments are populated accurately, including payer information, transaction details, and claims payment data.
What is the purpose of 835 Companion Guide?
The purpose of the 835 Companion Guide is to help healthcare entities understand and implement the electronic remittance advice process, providing clarity on the data elements and formats required for accurate and efficient processing.
What information must be reported on 835 Companion Guide?
The 835 Companion Guide must report information such as payer identifiers, claim payment amounts, adjustments, patient details, and service line-level details, along with any necessary remarks or notes related to the payments.
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