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EDI 837 Healthcare Claim Transaction - EDI 837 Transaction

EDI 837 Healthcare Claim Transaction

EDI 837 Healthcare Claim Transaction

The EDI 837 transaction is an electronic Healthcare Claim (also known as ANSI X12 EDI 837). An EDI 837 Healthcare Claim Transaction is a standardaized electronic medical transaction for healthcare providers, payors and clearinghouses that was implemented by HIPAA (Healthcare Insurance Portability and Accountability Act). An EDI 837 Healthcare Claim Transaction is the most commonly used medical transaction which is submitted by healthcare providers, hospitals and medical facilities to submit a claim for payment.

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  • Healthcare providers can automate healthcare procurement and simplify vendor onboarding
  • Enhances operational efficiencies for HIPAA claims processing
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EDI 837 Healthcare Claim Transaction includes:

  • Healthcare provider details
  • Patient medical information
  • Patient insurance plan
  • Services provided, diagnosis code(s) and procedures code(s) if applicable

EDI 837 Healthcare Claim Transaction benefits:

  • Improves accuracy of information exchanged for all parties - patient, healthcare provider, insurance payor and clearinghouse 
  • Identifies errors and prevents processing delays allowing timely filing
  • Ensures secure and reliable claims processing
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