HIPAA-AS
Questions and Answers Format 837: Health Care Claims
Q. How do I register to submit claims electronically?
A. Complete the registration forms. If assistance is needed to complete the forms, contact EC Solutions at 800-407-0267. Note: You must be enrolled with Wellmark to complete the registration process. See Enrollment under Working with Wellmark.
Q. How do I get help finding a method to send claims?
A. 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 837 transaction version should be used by different providers (e.g. ambulatory surgical centers) for Wellmark?
A. The 837 transaction table (57K PDF) identifies eligible provider types in Wellmark Blue Cross and Blue Shield in Iowa and South Dakota and the corresponding version of the 837.
Q. What reports are available?
A. 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. For information on these reports see the Electronic Claims Report Manual.
Q. What is the acceptable electronic claim format?
A. Submitters are required to send claims in a HIPAA-compliant format (ANSI 837x4010A1 transaction).
Q. How do I submit claims electronically?
A. See How to Submit Claims Electronically.
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