EDI loop for billing, pay to and rendering provider info

Electronic Data Interchange

The Health Insurance Portability and Accountability Act (HIPAA) requires compliance with the Electronic Data Interchange (EDI) standards. Providers should follow the HIPAA transaction and code set requirements as found in the National Electronic Data Interchange Transaction Set Implementation Guides. The following provides details from the Implementation Guides to accommodate NPI within the 837 and 835 EDI transactions. Failure to comply with the 837 standards will result in a rejection of the claim.

837 Health Care Claim Submissions