277CA transaction example and description The purpose of the 277CA (Claims Acknowledgement) transaction is to provide a claim level acknowledgement of all claims received in the pre-processing system before submitting claims into a payer’s adjudication system. It is believed that most payers are using the 277CA as their standardized reporting mechanism for 5010. The 277CA … Read More →
837 Transaction sending by a third-party provider 837 Transaction allows claims to be submitted from Professional, Institutional or Dental Provider of Service in a standard format mandated by the Department of Health and Human Services. As we mentioned in our previous posts, 837 Transaction is designed to allow a Provider of Service’s practice management software to … Read More →
837 Institutional Claim scenario and mapping guidelines 837 Institutional Claim example presented in today’s post shows a standard 837 Institutional claim. As we spoke in our previous post, the 837 Healthcare Claim transaction has three different implementation guides specifically developed for Professional, Institutional and Dental claims. The specifications are geared to meet the individual requirements … Read More →
837 Professional Claim scenario and raw data 837 Professional Claim example mentioned in this post shows a standard 837 Professional claim file. It includes data from the provider of Service indicating the member’s demographic information, diagnosis, services rendered and charges. 837 Professional Claim data will be used by the Insurance Company to determine what benefits … Read More →