The EDI 835 standard is known as the Health Care Claim Payment / Remittance Advice Transaction Set. This fairly complex transaction set is HIPAA-mandated, ubiquitous in the health care industry, and applicable to two fundamental processes:

  • Sending payment for a claim
  • Sending explanations of benefits (EOB) / explanations of payment (EOP) / remittance advice

Effectively, an EDI 835 transaction provides further information about an EDI 837 claim. More than one 837 transaction can supplement an 835 transaction, and vice-versa. When properly configured, the EDI 835 standard not only helps medical billing services toward HIPAA compliance, but makes medical clearinghouse interactions faster and less error-prone.

Handling Medical Clearinghouse Data for EDI 835

Too often, medical billing processes begin with paper data like faxes and hard-copy records—even for digital and largely automated processes such as EDI 835 transactions. This can be a substantial drain on resources, as well as a source of easily avoidable errors.

However, data extraction from forms and other data sources can be automated with extraordinarily accurate and cost-effective software. Furthermore, medical billing offices can typically design a workflow that “outsources” scanning to the senders, without increasing anybody’s workload. The end result is the near-elimination of paper from business processes, accompanied by rapid ROI due to cost savings, and minimized human error.

Medical Billing Data Capture & EDI Data Automation

Paperless Productivity has developed unique and deep expertise in automating data capture for medical billing, health care clearinghouses, providers/hospitals, and insurers. We understand that accuracy is paramount not only to financial efficiency, but to patient care and satisfaction.

Contact us to arrange a free, value-added consultation with a data capture and automation expert.

Meanwhile, learn more about data capture automation for medical clearinghouses / billing firms using EDI 820 and EDI 837.