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Back   Post Adjudicated Claims Data Reporting: Professional (008010X298)

Purpose

The Post Adjudicated Claims Data Reporting: Professional Implementation Guide describes the use of the ASC X12 Health Care Claim (837) transaction set for reporting health care professional service post adjudicated data:
  • to satisfy state and federal reporting requirements such as; Medicare and Medicaid encounters, All Payer Claims Databases, and Health Care Insurance Exchanges
  • for use in health data analysis from payer data

Primary Trading Partners

Trading partners may include but are not limited to:
  • Payer
  • State agency or designee
  • Federal agency or designee
  • Insurance Exchanges

Exceptions/Limitations

Reporting by providers

Coordination

X12 TGB/WG2

Additional Information

Registered 2/1/2020
Transaction Set ID 837 Standard Version 008010
ASC X12 DM# 005219 Owning Group X12N/TGB/WG22