Chapter 1. Purpose and Business Information

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1.1 Implementation Purpose and Scope

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For the health care industry to achieve the potential administrative cost savings with Electronic Data Interchange (EDI), standards have been developed and need to be implemented consistently by all organizations. To facilitate a smooth transition into the EDI environment, uniform implementation is critical.

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This is the technical report document for the ASC X12N 837 Health Care Claims (837) transaction for professional claims, encounters, and/or requests for predetermination of benefits (estimates). Unless noted otherwise, the term "claim" in this guide applies to all these uses. See Section 1.5 - Business Terminology for definitions. This document provides a definitive statement of what trading partners must be able to support in this version of the 837.

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