The EDI 837 can be used by Healthcare insurance plans to submit health care claim billing information, encounter information, or both, from providers of health care services to payers, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit health care claims and billing payment information between payers with different payment responsibilities where coordination of benefits is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of health care services within a specific health care/insurance industry segment. For assistance meeting the requirements of your trading partners please contract Atadex EDI to discuss the implementation.

An EDI 837 may provide the following information:

* Patient description
* Patient condition for which treatment was provided.
* Services provided
* Cost of treatment

This is a sample EDI 837 raw data:

BHT*0019*00*250435*20101118*1206*RP~
REF*87*004010X098A1~
NM1*41*2*MISYS HEALTHCARE*****46*561306083~
PER*IC*MISYS FASTCLAIM SUPPORT*TE*8003473473~
NM1*40*2*BLUE SHIELD OF CALIFORNIA*****46*940360524~
HL*1**20*1~
NM1*IL*1*CAHILL*JAMES*M***MI*J92087254~
N3*1326 N 47TH ST~
N4*SACRAMENTO*CA*95826~
DMG*D8*19430426*M~
NM1*PR*2*BLUE SHIELD*****PI*94036~
N3*PO BOX 1505~N4*REDBLUFF*CA*96080~
CLM*001000222500*238***11>>1*Y*A*Y*Y*B~
AMT*F5*20~
REF*EA*186675~
HI*BK>30000*BF>6019*BF>V700*BF>78650~
NM1*DN*1*QUACH*HUNG*T***XX*1255428975~
NM1*82*1*BLANK*DAVID*S***XX*1770678070~
LX*1~
SV1*HC>99212>25*55*UN*1***1>2~
DTP*472*D8*20100101~
REF*6R*000000002644869~
LX*2~
SV1*HC>99396*140*UN*1***3~
DTP*472*D8*20100101~
REF*6R*000000002644870~
LX*3~
SV1*HC>93000*43*UN*1***4~
DTP*472*D8*20100101~
REF*6R*000000002644871~
HL*3*1*22*0~
SBR*P*18*000MRD1000000******BL~
NM1*IL*1*TEST*RO2*1***MI*J92063170~
N3*6300 CANOGA AVE~
N4*WOODLAND HILLS*CA*91367~
DMG*D8*19400322*M~
NM1*PR*2*BLUE SHIELD*****PI*94036~
N3*PO BOX 1505~
N4*RED BLUFF*CA*96080~
CLM*001000222510*59***11>>1*Y*A*Y*Y*B~
AMT*F5*20~
REF*EA*186675~
HI*BK>30000*BF>6019~
NM1*DN*1*QUACH*HUNG*T***XX*1255428975~
NM1*82*1*BLANK*DAVID*S***XX*1770678070~
LX*1~
SV1*HC>99212>25*59*UN*1***1>2~
DTP*472*D8*20100101~
REF*6R*000000002644869~

Sources: Accredited Standards Committee X12. ASC X12 Standard (www.x12.org)