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837 Companion Guide – Header and Submitter Information

The following sections explain how to populate the ISA, GS, and 1000A loops when sending 837 files to ClaimRev.

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ISA Segment (Interchange Control Header)

The ISA segment is the fixed-length envelope header that begins every 837 EDI transaction.

Element	Name	Req	Length	What to Use
ISA01	Authorization Info Qualifier	R	2	00 (No authorization info)
ISA02	Authorization Info	R	10	0000000000
ISA03	Security Info Qualifier	R	2	00 (No security info)
ISA04	Security Info	R	10	0000000000
ISA05	Interchange ID Qualifier (Sender)	R	2	ZZ
ISA06	Interchange Sender ID	R	15	Account Number (space-filled)
ISA07	Interchange ID Qualifier (Receiver)	R	2	ZZ
ISA08	Interchange Receiver ID	R	15	CLAIMREV
ISA09	Interchange Date	R	6	YYMMDD
ISA10	Interchange Time	R	4	HHMM (24-hour)
ISA11	Repetition Separator	R	1
ISA12	Interchange Control Version	R	5	00501
ISA13	Interchange Control Number	R	9	Unique, matches IEA02
ISA14	Acknowledgment Requested	R	1	0 or 1
ISA15	Usage Indicator	R	1	T = Test, P = Production
ISA16	Component Element Separator	R	1	:

Example ISA (Production): ISA*00*00*ZZ*SUBMITTERID*ZZ*CLAIMREV*2509031200*^00501*00000000*10*P*:~

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Element	Name	Req	Length	What to Use
GS01	Functional ID Code	R	2	HC
GS02	Application Sender’s Code	R	2–15	Same as ISA06
GS03	Application Receiver’s Code	R	2–15	CLAIMREV
GS04	Date	R	8	CCYYMMDD
GS05	Time	R	4–8	HHMM or HHMMSS
GS06	Group Control Number	R	1–9	Unique, matches GE02
GS07	Responsible Agency Code	R	2	X
GS08	Version/Release/Industry Identifier	R	1–12	005010X222A1

Example GS (Production): GS*HC*SUBMITTERID*CLAIMREV*20250903*12001*X*005010X222A1~

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This loop identifies the entity (provider or billing service) submitting the claim.

Element	Name	Req	What to Use
NM101	Entity Identifier Code	R	41 (Submitter)
NM102	Entity Type Qualifier	R	2 (Non-Person Entity)
NM103	Submitter Name	R	Submitter’s organization name
NM104–NM105	Not Used	–	Leave blank
NM108	Identification Code Qualifier	R	46
NM109	Identification Code	R	Submitter ID (same as ISA06/GS02)

Example NM1: NM1*41*2*YOUR CLINIC*46*SUBMITTERID~

This segment is REQUIRED. Providers must include at least one valid contact method.

Element	Name	Req	What to Use
PER01	Contact Function Code	R	IC (Information Contact)
PER02	Name	R	Contact Person’s Name
PER03	Communication Number Qualifier	R	TE (Telephone)
PER04	Communication Number	R	Phone number
PER05	Communication Number Qualifier	O	EM (Email)
PER06	Communication Number	O	Email address

Example PER: PER*IC*John Smith*TE*5551234567*EM*jsmith@yourclinic.com~