Encounter Data System - CSSC Operations

TABLE 4 - 837 INSTITUTIONAL HEALTH CARE CLAIMLoop ID Reference Name Codes Notes/CommentsBHT Beginning of HierarchicalTransactionBHT03Originator ApplicationTransaction IdentifierMust be a uniqueidentifier across all filesBHT06 Claim Identifier CH Chargeable1000A NM1 Submitter NameUsed to identify file levelduplicates collectively withISA13, GS06, and ST02.NM102 Entity Type Qualifier 2 Non-Person EntityNM109 Submitter Identifier EN followed by ContractID Number1000A PER Submitter EDI ContactInformationPER03PER05PER07Communication NumberQualifierCommunication NumberQualifierCommunication NumberQualifier1000B NM1 Receiver NameTEEMFXIt is recommended thatMAOs and other entitiespopulate the submitter’stelephone numberIt is recommended thatMAOs and other entitiespopulate the submitter’semail addressIt is recommended thatMAOs and other entitiespopulate the submitter’sfax numberNM102 Entity Type Qualifier 2 Non-Person EntityNM103 Receiver Name EDSCMSNM109 Receiver ID 80881 Identifies CMS as thereceiver of the transactionand corresponds to thevalue in ISA08 InterchangeReceiver ID2010AA NM1 Billing Provider NameNM108 Billing Provider IDQualifierXXNPI Identifier837 Institutional Companion Guide Version 8.0/June 201214