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Back   Health Care Claim: Professional (006020X259)

Purpose

The Health Care Claim: Professional Implementation Guide describes the use of the ANSI ASC X12 Health Care Claim (837) transaction set to submit and transfer professional claims and encounters to primary, secondary, and subsequent payers.

Primary Trading Partners

Trading partners include:
  • Health care providers, such as physicians, practitioners, and suppliers
  • Health care and property/casualty (including workers' compensation payers
  • Clearinghouses, repricers, VANS, etc.

References

  • Health Care Claim: Professional (003070X066)
  • Health Care Claim: Professional (004010X098)
  • Health Care Claim: Professional (004050X143)
  • Health Care Claim: Professional (004060X194)
  • Health Care Claim: Professional (005010X222)

Coordination

ASC X12N Workgroup:
  • ANSI ASC X12N TG2/WG2 (Health Care Claims) developers for the dental, institutional, and workers’ compensation implementation guides.
  • ANSI ASC X12N TG2/WG3 (Health Care Claim Payment)
  • ANSI ASC X12N TG2/WG4 (Health Care Enrollments)
  • ANSI ASC X12N TG2/WG5 (Health Care Claim Status)
  • ANSI ASC X12N TG2/WG9 (Patient Information & Attachments)
  • ANSI ASC X12N TG1/WG3 (Workers' Compensation and Disability)

Additional Information

Registered 9/27/2006
Transaction Set ID 837 Standard Version 006020
ASC X12 DM# Owning Group X12N/TG2/WG2/837P