HIPAA EDI Guide for 837 Transactions

An electronic document used to replace,
update, or cancel shipment along with creating new shipment.


Understanding EDI, its transactions, and other concepts can be a tough row to hoe. However, businesses need to be on their toes when it comes to EDI transactions and formats. Hence, we have prepared a comprehensive EDI companion guide in respect to ASC X12N 837 standards for EDI technical report type 3 and WebMD/Emdeon Business Services Companion Guides. In this detailed guide, we have defined EDI communication specifications, Health Partners Plans business rules, and applicable information to 837 Institutional (I) and Professional (P) transactions. Health Partners Plans use and accept standard code sets on the 837 transactions.

Health Partners Plans will receive HIPAA X12N 837 I & P transactions from WebMD/Emdeon Business Services and revert with valid X12N transactions. You can contact the billing software provider to request claims and submit encounters through the WebMD/Emdeon Business Services claims clearinghouse. Also, you can direct the current clearinghouse to forward claims to WebMD/Emdeon Business Services. The information provided in this e-book intends to guide you through a companion document to HIPAA X12N 837 Institutional and Professional Standards for electronic data Interchange Technical Report Type 3.


  • 837 Institutional Claims
  • 837 Professional Claims
  • General Requirements for Claim Submission (837 I & P Claims)


  • This ebook guide will help you understand 837 Institutional and Professional Claims.
  • Get to know general requirements for electronic claims submission (837 Institutional & Professional).
  • Identify various issues that will facilitate the Institutional & Professional Claims Submission Process.
  • General business requirements for 837 Institutional & Professional Claims (5010A2 and 4010A1)

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