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 to facilitate consistent implementation 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 institutional 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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