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Credentialing Glossary

EDI 837

billing

Definition

X12 healthcare claim transaction. 837P is professional, 837I is institutional, 837D is dental. Required HIPAA standard for electronic claim submission. Submitted to clearinghouses or directly to payers. Common rejection causes at the 837 level: missing taxonomy code (loop 2310B), invalid NPI, missing prior authorization number when required, mismatched subscriber/dependent information.
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