EDI 837: Healthcare Claim Transaction
Healthcare institutions are frequently required to share documents with a variety of partners resulting in large amounts of data input and transferring. These processes can be error-prone and tedious when done manually.
The EDI 837 is the electronic submission format of health care claim information that is structured to meet HIPAA requirements.
When using EDI integration, the EDI 837 form is created with zero risks of data entry and is done in a seamless and time-efficient process. At Effective Data, we offer complete healthcare EDI services. We are dedicated to providing a secure and flexible structure for healthcare systems to efficiently and safely share documents.
Medical claims for healthcare can either be manually entered into an EDI standard document or pulled from data integration through your in-house EDI system.
Once the data has been entered into the EDI translator, it will begin the conversion process into an EDI 837 document. This conversion process follows specific guidelines that have been set into place by the ASC X12 and meets HIPAA-based EDI requirements.
EDI 837 transactions often include information such as:
- Patient Description
- Patient’s Condition and Treatment
- Services Provided
- Cost
These transactions are divided into three groups per 5010 of the HIPAA EDI standards.
- EDI 837P for Professionals
- EDI 837I for Institutions
- EDI 837D for Dental
Sending medical information requires strict and secure processes. At Effective Data, our EDI solutions provide complete security and knowledge of the EDI transmission process.
EDI 837 transactions are most commonly sent directly to the receiver where the receiver of the EDI 837 decodes the EDI into a document that can be used by the recipient. The second way of sending the EDI 837 is to send it via a secure dial-up connection to a Value-Added Network (VAN) and then is routed to the recipient.
Healthcare EDI Solutions
At Effective Data, we support all major EDI communication methods while maintaining knowledge of changing industry standards and trends. We understand that the management of patient documents is of critical importance and requires absolute security.
We specialize in helping healthcare industry businesses securely automate and improve processes while maintaining compliance with all healthcare requirements. Our services include:
- Cloud EDI
- Off-premise EDI
- On-premise EDI
- Hosted EDI
- EDI Assessment
- HIPAA Level-7 Integration
- Strategy Consulting
- Process Automation
- VAN Services
- And More
We offer full-service, one-on-one support for all of your needs.
To improve patient care by maximizing security and productivity with HIPAA-compliant EDI services, contact us below for more information.