Health Care Service: Data Reporting (006020X262)

Purpose

The Health data Reporting Implementation Guide describes the use of the ANSI ASC X12 Health Care Claim (837) transaction set for the following business usages:

Reporting health care service data for use in health data statistical analysis from provider data
Reporting health care service data to satisfy governmental mandates necessary to regulate the health care industry
Reporting health care service data to measure utilization rates

Primary Trading Partners

Trading partners include:

Health care providers, such as, hospitals and physicians
Health care payers, such as, insurance companies, HMO's, and PPO's
Local, state, and federal governmental authorities or their reporting agents
Trade organizations, such as, hospital associations

Exceptions/Limitations

Intended as a vehicle to report health care service data to authorized authorities or based on trading partner agreement. It is not intended to satisfy all health care reporting needs. It excludes encounters reporting between providers and health plans.

References

Health Care Service: Data Reporting (004050X156)
Health Care Service: Data Reporting (005010X225)

Coordination

ASC X12N Workgroup:

ANSI ASC X12N TG2/WG2 (Health Care Claims)
ANSI ASC X12N TG2/WG9 (Patient Information & Attachments)

Additional Information

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