837 Implementation

WHAIC 837 File Submission & Testing Instructions

WHAIC Testing Defined Requirements 

WHA Information Center requires all facilities to successfully complete testing prior to advancing to the 837 data submission in production.  Each facility must adhere to the technical specifications in the WHAIC 837 Companion Guide as provided below and produce a HIPAA compliant 837 transaction file.  Testing is based on individual locations and facility ID, not hospital / ASC affiliation or number of facilities in a hospital system.

WHAIC is asking facilities to work closely with use to perform comparative testing by submitting dual test files - submit one file in the current .txt file format and another in an 837 format.  Before you contact WHAIC to validate your data or address questions, please verify and evaluate your test results using the check list located within this document. 

WHAIC 837 File Submission & Testing Instructions | DOWNLOAD
Last updated June 27, 2017

 

General Companion Guide:  837 Institutional and Professional Healthcare Claims Submission - Version 5010

 Version Effective Date:  April 1, 2017

This document has been prepared as a Wisconsin Hospital Association Information Center (WHAIC) WIpop specific companion document to support the ANSI ASC X12N837 Health Care Claims (837) transaction for institutional and professional reporting of claims transactions detail into the WIpop data submission site.

The information in the document should be used to clarify when specific transaction instructions are required, situational or mapped data fields used for reporting to WHAIC. Last update on June 21, 2017.  For further information, please contact Cindy Case.

  1. Introduction
  2. General Information & Overview
  3. File Submission
  4. Claim Submission Guidelines and Technical Requirements
  5. Required Data File Formats & Data Elements
  6. Batch Files, Edits and Validation / Affirmation Process
  7. Appendices
    1. Facility List
    2. Race & Ethnicity
    3. Payer Mapping
    4. Type of Bill
    5. Place of Service
    6. Coding Guidelines
    7. Point of Origin for Admission or Visit
    8. Patient Discharge Status
    9. WIpop Edit Codes and Descriptions
    10. Access to WIpop Data Submission System
    11. Marital Status Codes
    12. De-identification of Name to Create UCID / ECID
      • Black Box Program and Instructions | DOWNLOAD
    13. Data Dictionary
    14. Terms and Acronyms Definitions
    15. Manual Data Entry
    16. FAQ

DOWNLOAD the entire manual.

 

Previous 837 Project Announcements

Previous 837 documentation will be archived on this page as WHA Information Center continues to provide new information to the data submitters.