Electronic processing of insurance claims and payment data Forms for Santa Clara
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FAQ
The 837i is the electronic version of the paper form UB-04. 837i files are used to transmit institutional claims. Institutional claims are those submitted by hospitals and skilled nursing facilities. The 837p is the electronic version of the CMS-1500 form.
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 two most common claim forms are the CMS-1500 and the UB-04. The UB-04 (CMS 1450) is a claim form used by hospitals, nursing facilities, in-patient, and other facility providers. A specific facility provider of service may also utilize this type of form.
The 837P (Professional) is the standard format health care professionals and suppliers use to send health care claims electronically. The ANSI ASC X12N 837P (Professional) Version 5010A1 is the current electronic claim version.
An electronic claim is a paperless patient claim form generated by computer software that is transmitted electronically over telephone or computer connection to a health insurer or other third-party payer (payer) for processing and payment.
Since then, the UB-04 has been the standardized form used by hospitals, ambulatory surgery centers, nursing facilities, and other medical and mental health institutions. These claims forms can be submitted both electronically and on paper.