ANSI 837 - Florida Blue - BCBSF

Florida Blue 837 P Companion Guide 2012VI.837P Control Segments & EnvelopesReq #G1Loop ID – Segment Description& Element NameAll Transactions for Availity UsersonlyTR3 DataElementGlobal InformationTR3 Page(s)Plan RequirementFlorida Blue requires a Trading Partner Agreementto be on file with Availity indicating all electronictransactions the Trading Partner intends to send orreceiveG2 All Segments Only loops, segments, and data elements valid forthe 837 HIPAA-AS TR3 Guide ASC X12005010X222A1 will be used for processing.G3 Acknowledgements –Florida Blue acknowledgementsare created to communicate thestatus of transactions. It isimperative that they be retrievedon a daily basis. One file couldresult in multipleacknowledgements.ANSI X12:TA1 is available immediately after “depositing file”999 is available immediately after “depositing file”Files and/or claims that do not pass edits areindicated on these acknowledgements and must becorrected and resubmitted.Availity Users: Availity will forward Florida Blueacknowledgements to the submitter. Please referto the Availity EDI Guide at www.Availity.com.- TA1 – InterchangeAcknowledgement- 999 – FunctionalAcknowledgementG4 Negative Values Submission of any negative values in the 837transaction is not allowed.G5 Date fields All dates submitted on an incoming 837 HealthCare Professional Claim must be a valid calendardate in the appropriate format based on therespective TR3 qualifier. Failure to do so maycause processing delays or claims being returned asa provider correctable error. These must be101 Availity, LLC Is a multi-payer joint venture company. For more information or to register, visit Availity’s website atwww.availity.com.900-3398-1112005010X222A1Florida Blue December 2012