Skip to content
New issue

Have a question about this project? Sign up for a free GitHub account to open an issue and contact its maintainers and the community.

By clicking “Sign up for GitHub”, you agree to our terms of service and privacy statement. We’ll occasionally send you account related emails.

Already on GitHub? Sign in to your account

EDI Claim 837 Mandatory Feild Details #12

Open
nigamabhay671 opened this issue Dec 1, 2018 · 1 comment
Open

EDI Claim 837 Mandatory Feild Details #12

nigamabhay671 opened this issue Dec 1, 2018 · 1 comment

Comments

@nigamabhay671
Copy link

Hello guys i am working on ediclaim837 i need some help with you guys
I have Some Doubts in filling Some values to Loop Segments and also please tell me from where i get this values and also tell me that which are the mandatory fields....

1.) Submitter Loop or Clearing House =====>Submitter Name,Submitter Id
2.) Receiver Loop or Insurance Company=====>Reciever Name,Receiver Id,
3.) Billing Provider =====>Billing Provider Id,Name,Address,Zip,ContactNumber,Billing Provider Tax Identification
4.) Claim Information =====>Claim identification Number,Patient Control Number,Total Amount Charge,Facility Code Qualifier,Frequency Type Code , Provider Signature Indicator,Provider Accept Assignment,Provider Benefits Assignment Certification(Yes for Valid Signature on File/No for No Valid Signature on File),Client Signature Source Code,Reference Identifier Code Qualifier,Reference ReferenceId,HealthCare Code Information,Health Care Diagnosis Code.
5.) Rendering Provider Loop ======>Rendering Provider Name,Identifier Code,Provider Taxonomy Code,Secondary Indentification Reference ID.
6.) Subscriber Loop ======>Patient Account Number,Policy/Group Number,Plan/Program,Medicare Secondary Payer(MSP) code,Member ID(Identification Code)

@nwlynch
Copy link

nwlynch commented Apr 19, 2020

I know it's been a while, but your claims processing entity should have documentation that lists mandatory or situational segment requirements. CMS, Blue Cross etc have things called "Companion Guides" for 837P, 837I or 837D files. (Among others)

Sign up for free to join this conversation on GitHub. Already have an account? Sign in to comment
Labels
None yet
Projects
None yet
Development

No branches or pull requests

2 participants