EDI 835 : Health Care Claim Payment/Advice

The EDI 835 transaction is defined by the standard HIPAA 5010. It is required in the electronic transmission of payments and beneficiary information in the medical field.

EDI 835 is used primarily by medical insurance companies to make payments to providers of medical services, to provide explanations to beneficiaries, or both. When the medial service provider uses an EDI 837 Health Care Claim, the insurance provider uses the 835 transaction to send details of the payment. This includes:
  • What charges have been paid, reduced or denied
  • What parts are deductible, co-insured, co-pay
  • Information on mixing or separation of various claims
  • How payments were made
  • A description of the patient
  • The condition of the patient
  • Services provided to the patient
  • The cost of treatment
Faxinating Solutions can help you quickly integrate a low cost EDI solution that will allow you to process EDI 835 transactions. Regardless of the source of the information, we will ensure that you become EDI compliant.

How do I send an EDI 835 transaction?

Faxinating Solutions can help you quickly integrate a low cost solution to process EDI 835 transactions.

Call us now at 1-800-282-6283, ext. 231 to arrange a free demonstration.