835 and 837 HIPAA

835 and 837 Files Frequently Asked Questions

The 835 and 837 transactions form the backbone of electronic data interchange in healthcare finance, facilitating seamless communication and transaction processing between payers and providers. Let’s take a look at the Frequently Asked Questions about 835 and 837 HIPAA transactions.

What is the main issue with healthcare claims and remittance?

The main issue is the mismatch between the initial 837 claim and the final 835 payment, often due to inaccurate deposit information or wrong account postings.

What is an 837 file used for?

An 837 file is a HIPAA form used by healthcare providers to communicate healthcare claims to insurance providers electronically.

What information does an 835 file contain?

An 835 file contains payment information, including medical treatment details, insurance data, deductibles, co-pay amounts, claim splitting, co-insurers, and bundling.

How can software solutions help with 835 and 837 file discrepancies?

Software solutions can automatically reconcile discrepancies between the files, improving efficiency and financial management for healthcare organizations.

By leveraging standardized formats and protocols, these transactions promote efficiency, transparency, and accuracy in financial transactions.

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