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AETNA BETTER HEALTH OF NEBRASKA Claim Requirements: Taxonomy, NPI, and Zip+4 Aetna Better Health is required to provide specific information from all claims to the State of Nebraska. Beginning 8/25/2014,.

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>> DEFINITION OF PATIENT ENCOUNTERS CMS defines patient encounters as any encounter where a medical treatment is provided and/or evaluation and management services are provided, except a hospital inpatient department (Place of Service 21) or a hospital emergency department (Place of Service 23).

In short, 837 data is how a claim is sent electronically. An 835 is also known as an Electronic Remittance Advice (ERA). It is the electronic claim payment information and documents the electronic funds transfer (EFT). The 835 data shows how the claim is paid or denied electronically.

The 837I (Institutional) is the standard format used by institutional providers to transmit health care claims electronically. The Form CMS-1450, also known as the UB-04, is the standard claim form to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.

The purpose of EDI is to transmit information to other companies electronically instead of using paper. EDI 837 is specifically used for filing claims and for sending medical and healthcare data records to brokerage houses.

What is an 837 File? An 837 file is an electronic file that contains patient claim information. This file is submitted to an insurance company or to a clearinghouse instead of printing and mailing a paper claim. The data in an 837 file is called a Transaction Set.

The code that identifies a significant event relating to an institutional claim or encounter record that may affect payer processing. These codes are associated with a specific date (the claim related occurrence date).

In professional billing, the 837-P, which is the electronic equivalent of the CMS 1500 form, is employed. Professional configuration is denoted by the letter “P.” For institutional billing, the UB-04 form is utilized. The 837-I is used in institutional billing for electronic claims.

The X12 837 and 835 files are industry standard files used for the electronic submission of healthcare claim and payment information. The 837 files contain claim information and are sent by healthcare providers (doctors, hospitals, etc) to payors (health insurance companies).

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232