Announcing Public Review Periods for 4 Draft Implementation Guides

The following four implementation guides are available for public review beginning February 1, 2017. Each review period will close May 2, 2017 at 8:00 PM, Eastern Time. These guides have been developed by X12's Insurance subcommittee based on version 007030 of the X12 Standard.

  • The Health Care Claim: Professional 837 (007030X323)
  • The Health Care Claim: Institutional 837 (007030X324)
  • The Health Care Claim: Dental 837 (007030X325)
  • The Health Care Service: Data Reporting 837 (007030X326)

The Health Care Claim: Professional Implementation Guide describes the use of the ASC X12 Health Care Claim (837) transaction set to submit and transfer professional claims and encounters to primary, secondary, and subsequent payers.

The Health Care Claim: Institutional Implementation Guide describes the use of the X12 Health Care Claim (837) transaction set to submit and transfer institutional claims and encounters to primary, secondary, and subsequent payers.

The Health Care Claim: Dental Implementation Guide describes the use of the X12 Health Care Claim (837) transaction set to submit and transfer dental claims and encounters to primary, secondary, and subsequent payers.

The Health Care Service: Data Reporting Implementation Guide describes the use of the X12 Health Care Claim (837) transaction set for the following business usages:

  • Reporting health care service data for use in health data statistical analysis from provider data
  • Reporting health care service data to satisfy governmental mandates necessary to regulate the health care industry
  • Reporting health care service data to measure utilization rates.

The draft implementation guides are available in on-line forums at http://forums.x12.org. The draft information is provided for public review and cannot be used for any other purpose without permission from X12. Reviewers may submit comments on the drafts via the on-line forum. Instructions for reviewing the pages and submitting comments are posted on the forums page.

Interested parties may monitor all submitted comments and the associated responses via the on-line forums during the public review period and prior to the Informational Forums. To continue participating in our public review process, watch for the announcement of the corresponding Informational Forums.

Questions may be directed to info@x12.org.