Privacy Statement

Testing Rules

Transaction Testing

Companion Document

Claims Business Rules For 837 Test Files

PROFESSIONAL

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INSTITUTIONAL

Claim types/specialty should represent types of claims that would be submitted in a current production environment

Claim types/specialty should represent types of claims that would be submitted in a current production environment

Test with COB/supplemental claims (Secondary and coordination of benefit claims)

File must contain claims where the Patient is the Subscriber

File must contain claims where the Patient is the Subscriber

File must contain claims where the Patient is not the Subscriber

File must contain claims where the Patient is not the Subscriber

Must submit files for at least 2 submitters containing production-ready data

Must submit files for at least 2 submitters containing production-ready data