Which of the following is used to submit claims electronically via EDI format?

Study for the Certified Associate in Healthcare Information and Management Systems Exam. Utilize flashcards and multiple-choice questions with hints and explanations. Prepare effectively for your healthcare IT certification!

Multiple Choice

Which of the following is used to submit claims electronically via EDI format?

Explanation:
Electronic submission of health care claims uses standardized EDI transactions, with the claim carried on the 837 transaction. This format comes in versions for different claim types—837P for professional, 837I for institutional, and 837D for dental—providing a uniform set of data elements and codes so payer systems can automatically process and adjudicate claims. The other options are tied to paper forms or non-electronic methods: the CMS form 1500 is the traditional paper claim form for professional services, the CMS form 1450 (UB-04) is a paper form for institutional claims, and fax is not an electronic data interchange format.

Electronic submission of health care claims uses standardized EDI transactions, with the claim carried on the 837 transaction. This format comes in versions for different claim types—837P for professional, 837I for institutional, and 837D for dental—providing a uniform set of data elements and codes so payer systems can automatically process and adjudicate claims. The other options are tied to paper forms or non-electronic methods: the CMS form 1500 is the traditional paper claim form for professional services, the CMS form 1450 (UB-04) is a paper form for institutional claims, and fax is not an electronic data interchange format.

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