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What is an 837P?

Updated: 9/19/2023

Wiki User

∙ 13y ago

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837P stands for 837 Professional.

While EDI X12 formats are based on the standards in real world there are many deviations from the standard. Some deviations are so prevalent they become de facto sub standards in they own right. One of the best examples is EDI X12 837 Healthcare Claim.

Officially there is only one EDI X12 837. But due to very different requirements for institutional, dental and professional medical claims there are subsets for 837I, 837D and 837P. There is also probably a few hundred if not thousand variations of these.

Many trading partners you might need to deal with will provide you with they own document called "Companion Guide". These additional documents list specific requirements to they business needs.

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Can there be Multiple rendering providers in one ANSI 837P file?

Yes.

What is ansi x12 version 4010?

ANSI X12 is the EDI (Electronic Data Interchange) standard used primarily in North America. Any EDI standard provides specifications for the layout of common business documents, such as Purchases Orders, Invoices, Advance Ship Notices, Medical Claim Forms, and the like. EDI standards boards meet from time to time to discuss modifications to the standard. Version 4010 then, is just one of the versions of the ANSI X12 standard, just like 3040, 4020, 5010, etc. A new version of the standard does not render previous versions obsolete however; two parties exchanging X12 documents may use any version of the standard they wish. The current standards mandated in US for certain electronic medical transactions industry wide are in the ANSI, American National Standards Institute, X12 standing committee, n, insurance subcommittee, transaction sets. A transaction set is an electronic model of a paper transaction or form. The Standards for medical transactions are 837 for medical claims, 835 for medical claim payments, 270 eligiibility inquiry and 271 eligibility response, 276 claim status, 277 claims status response, 820 enrollmnet and 834 premium payments. These are currently mandated, 2008, to be in version 4 release 1 known as 4010. An ANSI standard needs an implementation guide to determine how much of the standard is used and how it is used. There are actually three types of claims represented by different implementation guides in the 837 transactin set. They are known in the industry as 837P for professional services, 837I for institutional services and 837D for dental services. Copies of these standards may be found at the web site of the Centers for Medicare and Medicaid Services contractor, WPC-EDI.com. There is a an expectation that the new standards will be anounced in early 2009 to be the version 5 release 1, known as 5010. The 5010 is essentially an updated 4010 with some of the confusion removed.

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