EDI 837 refers to a standard electronic data interchange (EDI) format used in the healthcare industry for the transmission of healthcare claims. It facilitates the exchange of information between healthcare providers and payers, streamlining the billing process and ensuring uniformity in data communication.
The EDI 837 transaction set is part of the X12 series of standards, which is overseen by the Accredited Standards Committee (ASC). This committee ensures that all EDI transactions adhere to a consistent format, making communicating easier for different healthcare entities.
The EDI 837 file contains detailed information about a patient’s healthcare encounter, including diagnoses, procedures performed, charges for services, and the patient’s insurance coverage details. This information is coded using standard medical coding systems such as the ICD (International Classification of Diseases), CPT (Current Procedural Terminology), and HCPCS (Healthcare Common Procedure Coding System).
