837P Companion Guide - Peach State Health Plan Peach State ...

Segment NotesElement ID Usage Guide Description/ValidCommentsValuesBHT01 R Hierarchical Structure Code 0019- Information Source,BHT02 R Transaction Set PurposeCodeSubscriber, Dependent00: Original18 ReissueBHT03 R Originator ApplicationTransaction IdentifierBHT04 R Transaction Set CreationDateBHT05 R Transaction Set CreationTimeSegment Name Transmission type IdentificationSegment IDREFLoop IDN/AUsageRequiredSegment NotesElement Usage Guide Comments36Use this referenceidentifier to identify theinventory file number ofthe tape or transmissionassigned by thesubmitter’s system.Date expressedCCYYMMDD. Use this dateto identify the date onwhich the submittercreated the file.Use this time to identifythe time of day that thesubmitter created the file.BHT06 R Claim or Encounter Identifier CH: ChargeableUse this code when thetransmission containsonly fee-for-service claimsor claims with at least onechargeable line item.RP: ReportingUse this code to send abatch of encounters.