compantion_guide
Differences
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| Next revision | Previous revision | ||
| compantion_guide [2025/09/03 13:46] – created brad.sharp | compantion_guide [2025/09/03 17:16] (current) – [GS Segment (Functional Group Header)] brad.sharp | ||
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| Line 20: | Line 20: | ||
| | ISA09 | Interchange Date | R | 6 | YYMMDD | | | ISA09 | Interchange Date | R | 6 | YYMMDD | | ||
| | ISA10 | Interchange Time | R | 4 | HHMM (24-hour) | | | ISA10 | Interchange Time | R | 4 | HHMM (24-hour) | | ||
| - | | ISA11 | Repetition Separator | R | 1 | ^ | | + | | ISA11 | Repetition Separator | R | 1 | < |
| | ISA12 | Interchange Control Version | R | 5 | 00501 | | | ISA12 | Interchange Control Version | R | 5 | 00501 | | ||
| | ISA13 | Interchange Control Number | R | 9 | Unique, matches IEA02 | | | ISA13 | Interchange Control Number | R | 9 | Unique, matches IEA02 | | ||
| | ISA14 | Acknowledgment Requested | R | 1 | 0 or 1 | | | ISA14 | Acknowledgment Requested | R | 1 | 0 or 1 | | ||
| - | | ISA15 | Usage Indicator | R | 1 | T = Test, P = Production | | + | | ISA15 | Usage Indicator | R | 1 | P = Production | |
| | ISA16 | Component Element Separator | R | 1 | : | | | ISA16 | Component Element Separator | R | 1 | : | | ||
| Line 46: | Line 46: | ||
| **Example GS (Production): | **Example GS (Production): | ||
| - | GS*HC*SUBMITTERID*CLAIMREV*20250903*12001*X*005010X222A1~ | + | GS*HC*SUBMITTERID*CLAIMREV*20250903*1200*1*X*005010X222A1~ |
| + | ==== 837 Transaction Versions ==== | ||
| + | |||
| + | The version identifier in the GS segment (GS08) and the ST segment (ST03) determines the type of 837 claim being sent. | ||
| + | |||
| + | ^ Claim Type ^ Common Name ^ GS08 / ST03 Version | ||
| + | | 837P | Professional | 005010X222A1 | Used for physician, outpatient, and supplier claims. | | ||
| + | | 837I | Institutional | 005010X223A2 | Used for hospital, facility, and institutional claims. | | ||
| + | | 837D | Dental | 005010X224A2 | Used for dental service claims. | | ||
| + | |||
| + | **Guidance: | ||
| + | - Choose the correct version based on the type of claim you are submitting. | ||
| + | - The rest of the GS and ST segments follow the same pattern, only the version code changes. | ||
| + | - ClaimRev accepts all three transaction types. | ||
| + | |||
| + | **Example (Professional Claim):** | ||
| + | GS*HC*SUBMITTERID*CLAIMREV*20250903*12001*X*005010X222A1~ | ||
| + | ST*837*0001*005010X222A1~ | ||
| --- | --- | ||
| + | |||
| + | |||
| + | |||
| ===== Loop 1000A – Submitter Name ===== | ===== Loop 1000A – Submitter Name ===== | ||
| Line 73: | Line 93: | ||
| ^ Element | ^ Element | ||
| | PER01 | Contact Function Code | R | IC (Information Contact) | | | PER01 | Contact Function Code | R | IC (Information Contact) | | ||
| - | | PER02 | Name | O | Contact Person’s Name | | + | | PER02 | Name | R | Contact Person’s Name | |
| | PER03 | Communication Number Qualifier | R | TE (Telephone) | | | PER03 | Communication Number Qualifier | R | TE (Telephone) | | ||
| | PER04 | Communication Number | R | Phone number | | | PER04 | Communication Number | R | Phone number | | ||
compantion_guide.1756907163.txt.gz · Last modified: 2025/09/03 13:46 by brad.sharp