Funding Source 837 Defaults

Define information that will populate the 837 Institutional and Professional files, for a funding source.

Avatar MSO > System Maintenance > Funding Source 837 Defaults

• This information is used to create the outbound 837 file through the 837 Outbound Processing form.

• If information filed in this form is the same as information entered in the Funding Source/Contracting Provider Reporting Defaults form, which overrides this form.

1. In the Funding Source field, select the funding source.

2. In the 'If The ISA Segment For A Particular Funding Source Is The Same For All Contracting Provider Combinations' field:

• Select Yes to create a single ISA segment.

• Select No to create an ISA segment for each 837 file.

3. In the Unique Interchange Control Number (ISA-13) For All Submissions' field, select Yes to use a unique interchange control number (ISA-13) for all submissions.

4. In the Current Interchange Control Number (ISA-13) field, enter the number.

5. In the Unique Control Group Number (GS-06) For All Submissions field, select Yes to use a unique control group number (GS-06) for all submissions.

6. In the Current Group Control Number (GS-06) field, enter the number.

7. In the Unique Transaction Set Control Number (ST-02) For All Submissions field, select Yes to use a unique transaction set control number (ST-02) for all submissions.

8. In the Current Transaction Set Control Number (ST-04) field, enter the number.

9. In the Unique Originator Application Transaction Identifier (BHT-03) For All Submissions field, select Yes to use a unique originator application transaction identifier (BHT-03) for all submissions.

10. In the Current Originator Application Transaction Identifier (BHT-03) field, enter the number.

11. In the Line Check or Remittance Date (837P-2430-DTP) field:

• Select Date Of Service to populate the 2430-DTP-03 with the date of service.
  If no selection is made the 2430-DTP-03 will populate with the date of service.
• In the 837 Professional Version 5010, if Date Claims Received is selected, the 2430-DTP-03 will populate with the Date Claims Received filed for the batch associated with the service.
• This field is not used in the 837 Professional Version 4010.

12. Click Submit.

• Allow Posting CPT Code Without Undefined Modifiers

• Enable 837 Outbound Version 5010

• Enable Claim/Service Note Override

• Enable Pay-To Provider Name (2010AB)

• Include Other Prov Info