Sample EDI 835 Data for the Health Care Claim Payment/Advice Transaction Set


AgencySet IDFGTransaction DescriptionSubcommitteeStandard
ANSI835HPHealth Care Claim Payment/Advice InsuranceDownload


Official Definition:
Data contents of the Health Care Claim Payment/Advice Transaction Set (835) for use within the context of the Electronic Data Interchange environment. This transaction set can be used to make a payment, send an Explanation of Benefits (EOB) remittance advice, or make a payment and send an EOB remittance advice only from a health insurer to a health care provider either directly or via a financial institution.

Example of an EDI 835 Transaction Set
Translate EDI 835   All 835 Guides  EDI 835 Segments   Need Help?
ST*835*000000001
BPR*DATA*NOT*VALID*RANDOM*TEXT
TRN*1*0000000000*1999999999
DTM*111*20090915
N1*PR*ALWAYS INSURANCE COMPANY
N7*AROUND THE CORNER
N4*SHINE CITY*GREEN STATE*ZIP
REF*DT*435864864
N1*PE*FI*888888888*P.O.BOX 456*SHINE CITY*GREEN STATE*ZIP*EARTH
LX*1
CLP*PCN123456789**5555.55**CCN987654321
CAS*PR*909099*100.00
NM1*QC*1*PATIENT*TREATED*ONE***34*333333333
DTM*273*20020824
AMT*A1*10.10
AMT*A2*20.20
LX*2
CLP*PCN123456789**4444.44**CCN987654321
CAS*PR*909099*200.00
NM1*QC*1*PATIENT*TREATED*TWO***34*444444444
DTM*273*20020824
AMT*A1*30.30
AMT*A2*40.40
SE*24*000000001

Solutions:
Are you looking to trade the EDI 835 transaction with one of your trading partners? Do you need an EDI VAN Savings solution to exchange the 835? Or perhaps you would like to use a Cloud-Based application, so you can plug your 835 transaction directly into your ERP and TMS systems. Even small companies have the ability to trade the 835 using an EDI Web Browser solution.



© Jobisez LLC - Contact Us  About Us  Privacy Statement  Sitemap  Jobisez Blog