Understanding the "Create 837 Transaction Sets" Window

Here you can find the descriptions of the "Create 837 Transaction Sets" window fields.

Query field — This field is located in the top left corner. It is used to narrow the records to be written to the EDI files. You can create your own query or you can use the query builder in the exported claims screen.
Live/Test Database radio buttons — They are located to the right of the query text box. They allow to choose between the Live database and the Test database as outlined in the data connection setup.
Effective date — It is the effective date of the file. By default, the current date is selected.
Version — Here you can select the version of the resulting EDI file. You have the choice of 4010 or 5010. It is generally possible to generate 4010 files from claims that came in 5010 files and vice versa, a third option is for claims that came from EDI files and that have been imported into the database. Here you have the option to preserve the original version so that a claim that came in an EDI file in 4010 format will also be output as 4010 files while a 5010 file will be output as 5010.

EDI Envelopes

The next part of the screen contains the EDI envelopes:

ISA Segment — The ISA segment contains the outermost envelope of the EDI file and it represents data that is required to read an EDI file. Listed here are the sender and receiver, the data and time, whether a response is expected and which characters to use as segment, element and sub-element separator. The picture above shows this screen and you can see the individual data elements. The data in black you can change, other elements are determined by the Company Setup screen.
GS Segment — The GS or Group Start segment contains transaction specific information, which transaction sets are in this file and also has information on the creation (Sender code) and consumption (Receiver Code) of the EDI files. Group control number and version will be filled in by the process since this is dependent on the claim type.
ST Segment — The ST or Start of Transaction Set segment again lists the transaction set code and a unique identifier for the transaction.
BHT Segment — The BHT segment further qualifies the claim in the 837 transaction set by specifying whether this is an original submission and whether the claims are chargeable or just encounter records.

 

If you have the EDI Exchange component licensed, you can select the trading partner and fill the form with a specific trading partner's information.

Select Trading Partner — Once this button has been clicked, a popup window appears where you can select your defined trading partner.

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