Adapting to the ANSI 835 transaction set.
Adapting to the American National Standards Institute (ANSI) 835 Health Care Claims Payment/Advice format--the first nationwide, all-payer electronic standard for healthcare claims--requires an approach tailored to the individual provider's system. Providers have four options for receiving ANSI 835 claims payments. They include: direct transmission from payers, value added network services (VANs), banks with electronic data interchange capabilities, and paper reports. Providers' claims processing systems vary enormously in the formats they use and in their capacities to transmit and receive claims payments electronically. Author Romo reviews factors that providers need to consider when refining internal capabilities and selecting external processors to accept the 835 format.
PNC Corporate Service, Philadelphia, PA.
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Romo
D000067:Accounts Payable and Receivable; D014487:Centers for Medicare and Medicaid Services, U.S.; D003195:Computer Communication Networks / Q000592:standards*; D005377:Financial Management, Hospital / Q000331:legislation & jurisprudence* / Q000379:methods; D007344:Insurance Claim Reporting / Q000592:standards*; D016344:Medicare Part A / Q000331:legislation & jurisprudence* / Q000592:standards; D014481:United States