837 file format

[olichap]

I'm looking at creating an application that accepts and parses EDI transactions in an 837 format but am unsure how the file itself is configured. I am unsure how the "loops" are put together to create a datastring, then the file as a whole.

A record starts and ends like so:

ST*837*872391~..........SE*54*872391~

If I had a batch of claims, would the text file look like this, where each claim takes up only one line:

ST*837*872391~..........SE*54*872391~
ST*837*872392~..........SE*54*872392~
ST*837*872393~..........SE*54*872393~

Or does the file look something like this:

ST*837*872391~..........SE*54*872391~
BHT*0019*00*0123*1970410*1339*CH~
SE*54*872391~

Thanks,

Oliver

 

[DonPedro05]

Hey Olliver,

Check out Washington Publishing company's website:

http://www.wpc-edi.com/hipaa/HIPAA_40.asp

down towards the bottom, you will find the 837 guide. I think you can download it for free, or pay $70 for a bound copy. It will have all the looping information and structure codes in the manual.

Good luck!

- PETE

 

[olichap]

Thanks Pete,

I have that doc now. It does not seem to give an example of more than one data string. I'm trying to find out whether all the data between the "ST" and "SE" elements are part of one long string that only wraps around because the doc needs to fit in on one page (where the next record would follow just below).

Also I am trying to find out how other people expect to see these data strings. At least one other company I've talked to, who processes this type of information for a number of clients, made mention of excepting the data in either different formats (namely the linear string-carriage return-then next record and the "ST"-cr-"BHT"-cr-"PRV"-cr-etc.-cr-"SE" formats). Which is the true standard? I assume the single data string.

Thanks,

O.

 

[DonPedro05]

I'm not sure which is standard. It depends on the method the client uses to transmit. If they use some sort of FTP or a Mailbox (like Advantis) and they pay a fee (usually per Kilo-Character), then usually they drop the carriage return and make it one long string.

But, I speak from experience with the 834 (Benefit Enrollment and Maintenance). I haven had any exposure to the 837, but the nature of EDI is that they should all work about the same.

As far as the ST/SE loop, (remember, this is 834 experience) just about all of my clients send all their members in one ST/SE envelope. I have suggested to some clients that they send multiple ST/SE loops because our translator rejects the whole envelope if one element fails compliance. If they send 10 ST/SE loops and one member fails compliance, then the 997 will report back to the client which loop failed and the other 9 loops will "make it through" the translator.

I know I got a little wordy there, but hope it helps.

- PETE