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Format 837: Health Care Claims

Q. How do I register to submit claims electronically?
Complete the Electronic Transaction Registration Packet  (563KB). If you need assistance to complete the forms, contact EC Solutions at 800-407-0267. Note: You must be enrolled with Wellmark to complete the registration process.


Q. How do I get help finding a method to send claims?
If you are concerned about finding a method for sending your claims electronically, please call the EC Solutions Sales team at 800-407-0267 and they can help you with a solution.

Q. What reports are available?
The first available report is the TXN which is an accept/reject report based on standard format and patient eligibility. The second report available is the Z16 which is an accept/reject report based on payer specifications.


Q. What is the acceptable electronic claim format?
Submitters are required to send claims in a HIPAA-compliant format (ANSI 837x4010A1 transaction).

Quick Links

Authorization to Use or Disclose Protected Health Information
»   Individual Authorization - Iowa - #S-53258 pdf image
»   Individual Authorization - South Dakota - #S-3315 pdf image
»   Designation of Authorized Representative - Iowa
- #S-53257 pdf image
»   Designation of Authorized Representative - South Dakota - #S-3316 pdf image
Authorized Representative Appointment and Authorization for Release of Information
»   Iowa - #C-5674 pdf image
»   South Dakota - #C-3617 pdf image

See Also

»   Electronic Transaction & HIPAA Guides
»   Electronic Transaction Registration Packet
- #S-53260 pdf image (563KB)
»   Submitting Electronic Claims
»   Testing Toolkit pdf image (199KB)
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