Exchanging Explanation of Payment Information between Providers and Health Plans (HIPAA 837 & 835)

Outlines practices to be followed by health plans and providers when creating and processing claims for patients that have more than one source of health care coverage. It also defines how the 837 Claims transaction and the 835 Payment/Advice transaction should be used to exchange Coordination of Benefits information between provider organizations and health plans.

BPR Category
HIPAA Transactions