EDI 835

The EDI 835 transaction set is an electronic version of a paper Healthcare Claim that complies with the ANSI X12 EDI specifications. HIPAA 5010 requires EDI 835 Healthcare Claim Payment and Remittance Advice transaction set for the electronic exchange of healthcare payment and benefit information. Healthcare insurance plans primarily use EDI 835 to make payments to healthcare providers, to provide Explanations of Benefits (EOBs), or both. When a healthcare service provider submits an 837 Health Care Claim, the insurance plan details the payment to that claim using the 835 including

Benefits of EDI 835 Health Care Claim Payment/Advice

• Eliminate manual keying; save time and effort
• Reduce posting errors
• Increase efficiency and save money

Other EDI transaction sets related to EDI 835 are:

• EDI 204 - Motor Carrier Load Tender
• EDI 210 - Motor Carrier Freight Details & Invoice
• EDI 214 - Transportation Carrier Shipment Status Message
• EDI 753 - Request for Routing Instructions
• EDI 810 - Invoice
• EDI 812 - Credit / Debit Adjustment
• EDI 820 - Payment or Order Remittance
• EDI 832 - Price/Sales Catalog
• EDI 830 - Planning Schedule with Release Capability
• EDI 837 - Healthcare Medical Claims
• EDI 846 - Inventory Inquiry
• EDI 850 - Purchase Order
• EDI 855 - Purchase Order Acknowledgement
• EDI 860 - Purchase Order Change Request
• EDI 867 - Product Transfer and Resale Report File Format
• EDI 870 - Order Status Report
• EDI 875 - Grocery Products Purchase Order
• EDI 990 - Response to a Load Tender
• EDI 997 - Functional Acknowledgment