Contracting Provider 835 Defaults
Define values to populate 835 files for a contracting provider.
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- Information in this form populates the interchange control header (ISA) in 835 files.
- One record can be associated with a contracting provider.
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In the Contracting Provider field, select the provider.
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In the Authorization Information Qualifier (ISA-01) field, select the authorization qualifier.
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In the Authorization Information (ISA-02) field, enter the authorization information.
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In the Security Information Qualifier (ISA-03), select the information qualifier.
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In the Security Information (ISA-04) field, enter the security information.
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In the Interchange Sender ID Qualifier (ISA-05) field, select the sender ID qualifier.
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In the Interchange Sender ID (ISA-06) field, enter the sender ID.
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In the Interchange Receiver ID Qualifier (ISA-07) field, select the receiver ID qualifier.
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In the Interchange Receiver ID (ISA-08) field, enter the receiver ID.
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In the Acknowledgement Requested (ISA-14) field, select the acknowledgement requested.
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In the Usage Indicator (ISA-15) field, select the usage indicator.
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Click File Contracting Provider 835 Defaults.
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Click Print Contracting Provider 835 Defaults to generate the Contracting Provider 835 Defaults Report, which details information entered in this form.