837 Professional Section

Populate 837P files.

Fields display the associated loop and segment that will populate.

The following fields are setup in the Dictionary Update form (RADplus Utilities).

• Provider Code (2000A-PRV-01)

• Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)

• Billing Provider Secondary Identification Qualifier

• Billing Provider Secondary Identification Code Qualifier - 2 (2010AA-REF-01)

• Billing Provider Secondary Identification Code Qualifier - 3 (2010AA-REF-01)

• Entity Type Qualifier (2010AB-NM1-02)

• Pay-to Identification Code Qualifier (2010AB-NM1-08)

• Reference Identification Qualifier (2010AB-REF-01)

• Payer Identification Code Qualifier

• Facility Type Code (2300-CLM-05-01)

• Release of Information Code (2300-CLM-09)

• Attachment Report Type Code (2300-PWK-01)

• Attachment Transmission Code (2300-PWK-02)

• Referring Provider Entity ID

• Entity Type Qualifier (2310A-NM1-02)

• Referring Provider Identification Code Qualifier (2310A-NM1-08)

• Reference Identification Qualifier (2310A-REF-01)

• Entity Type Qualifier (2310B-NM1-02)

• Rendering Provider Identification Code Qualifier (2310B-NM1-08)

• Reference Identification Qualifier (2310B-REF-01)

• Entity Identifier Code (2310D-NM1-01)

• Laboratory Or Facility Identification Code Qualifier (2310D-NM1-08)

• Referring Provider Reference ID Qualifier

• Authorization Information Qualifier (ISA-01)

• Security Information Qualifier (ISA-03)

• Interchange Sender ID Qualifier (ISA-05)

• Interchange Receiver ID Qualifier (ISA-07)

• Acknowledgement Requested (ISA-14)

• Usage Indicator (ISA-15)

• Claim Note Reference Code (837P-2300-NTE-01)

• Other Payee Insurance Type Code (2320-SBR-05)

• Other Payee Claim Filing Indicator Code (2320-SBR-09)

• Other Payee Patient Signature Source Code (2320-OI-04)

• Other Payee Release of Information Code (2320-OI-06)

• In the Coordination Of Benefits (2320/AMT) field, select the approved amount to include.
  This value determines the source of the service charge, or if the service charge will display.