ANSI 837 Reference

Default View | Segment Index

	Introduction


	Loop 0000A - INTERCHANGE CONTROL HEADER


	Loop 0000B - FUNCTIONAL GROUP HEADER


	Loop 0000D - TRANSACTION HEADER


	Loop 0000E - TRANSACTION HEADER


	Loop 1000A - SUBMITTER NAME


	Loop 1000B - RECEIVER NAME


	Loop 2000A - BILLING/PAY-TO PROVIDER


	Loop 2000B - SUBSCRIBER HIERARCHICAL LEVEL


	Loop 2000C - PATIENT HIERARCHICAL LEVEL


	Loop 2010AA - BILLING PROVIDER NAME


	Loop 2010AB - PAY-TO PROVIDER NAME


	Loop 2010BA - SUBSCRIBER NAME


	Loop 2010BB - PAYER NAME


	Loop 2010CA - PATIENT NAME


	Loop 2300 - CLAIM INFORMATION


	Loop 2310A - REFERRING PROVIDER NAME


	Loop 2310B - RENDERING PROVIDER NAME


	Loop 2310D - SERVICE FACILITY LOCATION


	Loop 2310E - SUPERVISING PROVIDER NAME


	Loop 2320 - OTHER SUBSCRIBER INFORMATION


	Loop 2330A - OTHER SUBSCRIBER NAME


	Loop 2330B - OTHER PAYER NAME


	Loop 2330F - OTHER PAYER PURCHASED SERVICE PROVIDER


	Loop 2400 - SERVICE LINE


	Loop 2410 - DRUG IDENTIFICATION


	Loop 2420E - ORDERING PROVIDER NAME


	Loop 2430 - LINE ADJUDICATION INFORMATION


	Loop 2440 - FORM IDENTIFICATION CODE

ANSI 837 to EZClaim Field Map

Use this field map to determine where data needs to be entered for the ANSI 837 electronic claim file.

Who is EZClaim? EZClaim is a provider of Medical Billing Software. Visit our home page at http://www.ezclaim.com.

What is an ANSI 837 file? The file format used for electronic billing of professional services (CMS-1500 billing). ANSI 837 is shorthand for the ASC X12N 837 (004010X098A1) file format.

What do I need to create ANSI 837 files? EZClaim Advanced with the ANSI 837 billing module is required for ANSI 837 billing. Our direct billing package contains all the software you need to bill electronically using the ANSI 837.

How to use this reference

If you receive an error report after submitting an ANSI file, there are three pieces of information required to locate the error:

Loop Number (ie 2010AA)
Segment Identifier (ie NM1)
Field Number (ie 09 or NM109)

With those three pieces of information, you can 'drill-down' to the exact field in EZClaim where the data is incorrect or missing.

Click the loop number on the left to list the available segments.
Select the segment to list the available fields.
Select the field number that contains the error.
The information will show EZClaim's screen, field name, valid values and other data entry notes as applicable.