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mbasso29 / GenerateEDI

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Research fields required for 837 files #5

Closed mbasso29 closed 1 year ago

mbasso29 commented 1 year ago

Determine what values are needed for an 837 file that need to be entered by the user.

mbasso29 commented 1 year ago

Example raw 837 file:

ISA*00* *00* *ZZ*999999 *ZZ*99999 *230131*1034*^*00501*000010184*0*P*:~
GS*HC*SENDCODE*SENDCODE*20230131*1034*10184*X*005010X223A2~
ST*837*10184*005010X223A2~
BHT*0019*00*10184*20230131*1034*CH~
NM1*41*2*Zirmed*****46*EDISUBID~
PER*IC*Erica DeVore*TE*7724031369*ED*EDIACCESS~
NM1*40*2*EDI 837*****46*SENDCODE~
HL*1**20*1~
PRV*BI*PXC*208100000X~
NM1*85*2*BaseQA Billing Provider Name*****XX*1124086160~
N3*223 Coastal View Drive Address Line1 Lng~
N4*Palm City*FL*34990~
REF*EI*659978412~
NM1*87*2~
HL*2*1*22*0~
SBR*P*18*******MB~
NM1*IL*1*OPACBFix*ClmHInstndry*A***MI*904773~
N3*4229 SW High Meadows Ave~
N4*Palm City*FL*34994~
DMG*D8*19730407*U~
NM1*PR*2*Med B Direct Bill Inst*****PI*10200~
N3*111 Apperson Way~
N4*Norcross*GA*30092~
CLM*10176*100.00***74:A:1**A*Y*Y~
DTP*434*RD8*20221201-20221201~
CL1*9*9*30~
REF*EA*904773~
HI*ABK:M6281~
HI*BH:11:D8:20221201*BH:29:D8:20221201*BH:35:D8:20221201~
HI*BE:50:::1~
CLM*10173*100.00***11:B:1*Y*A*Y*Y~
DTP*431*D8*20221201~
REF*EA*904770~
HI*ABK:M6281~
NM1*71*1*Flaherty*Test****24*999999999~
SBR*S*18*******MB~
OI***Y***Y~
NM1*IL*1*OPACBFix*ClmHInstndry*A***MI*904773~
N3*4229 SW High Meadows Ave~
N4*Palm City*FL*34994~
NM1*PR*2*Commercial Direct Bill Inst*****PI*904773~
N3*111 Apperson Way~
N4*Norcross*GA*30092~
LX*1~
SV2*0420*HC:97110:GP*100.00*UN*2~ ---- SV1 on professional claims
DTP*472*D8*20221201~
REF*6R*SVC265~
SE*44*10184~
GE*1*10184~
IEA*1*000010184~
mbasso29 commented 1 year ago

Values needed from user: Submitter name Application Receiver Code

Contact Name Phone Number Email address

Taxonomy Code Billing Provider Name NPI Number Physical Address Federal Tax Number Pay To Address

Payer Sequence Payer Name EDI Payer Identifier Payer Address

Patient Last Name Patient First Name Patient Middle Initial Medical Record Number Patient Address Date of Birth

Claim Number Total Claim Amount Type of Bill Claim Date Range Diagnosis Code(s)

Provider Last Name Provider First Name Provider Middle Initial Provider NPI

Physician Last Name Physician First Name Physician Middle Initial Physician NPI

Service Code Revenue Code Service Line Amount Service Units Date of Service