HIPAA 837-835 Billing Tool
This program helps you to reconcile medical claims in 837 files with payments in 835 files. It reads both 837 Professional files and 837 Institutional files.
Installation
This program is free to try. You can download it at Download page. Follow on screen instructions to install.
A new Icon will be placed on your Desktop after installation.
Run
Double click on the icon on your Desktop to start the program.
where "Claims Columns" in the left pane:
- Acc No: Patient Account number, patient control numbber
- Patient Last, First Name: Patient Name
- Amount: Total Claim Amount
-
Status: Claim payment status from 835 CLP 02 data
- 1: Processed as Primary
- 2: Processed as Secondary
- 3: Processed as Tertiary
- 4: Denied
- ...
"Claims Service Lines Columns" in the top right pane:
- Line No: Service line number, LX segment in loop 2400
- Ctrl No: Line Control Number in 837, match 835 Line Control Number
- HCPCS: HCPCS, CPT, or ... code
- Svc Date, End Date: Line item service date
- Amount: Line item amount
"Claims Payments Columns" in the bottom right pane:
- Status: payment status, 835 CLP 02, same as Status column in claim pane
-
Code: Claim Filing Code, 835 CLP 06
- 12: PPO
- 13: POS
- 14: EPO
- 15: Indemnity Insurance
- 16: HMO Medicare Risk
- ...
- HM: HMO
- MA: Medicare Part A
- MB: Medicare Part B
- MC: Medicaid
- ...
- Paid: Claim Paid Amount, 835 CLP 04
- Claimed: Claimed Amount, 835 CLP 03
- Patient Resp: Patient Responsible, 835 CLP 05
- Adjustments: Claim Level Adjustments codes and amounts
"Service Line Payments Columns" in the bottom right pane:
- Ctrl No: Line Control Number in 835, match 837 Line Control Number
- NUBC: Claim Paid Amount, 835 CLP 04
- HCPCS: HCPCS, CPT, or ... code
- Charged: Line item charged amount
- Paid: Line item paid amount
- Allowed: Line item allowed amount considered by payer
- Paid UOS: Line item paid unit of Service
- Adjustments: Line Level Adjustments codes and amounts
What is a Job
A job defines several 835 and 837 files for a billing period. You can save the job in a job file so you can open it later. Your 835 and 837 files defined in the job are never modified. This program reconciles claims in 837 files and payments in 835 files.
The job file is saved in "HSU Computing" folder under user "Documents" folder. You can use "Settings" menu to change this default location.
Create a New Job
Click on "New Job", program displays:
Use "Add File" button to add files to the job,
"Remove File" button to remove a file from the job, and
"Save" button to save the job to a file so you can open it later.
For example, you can create a job includes the following 4 files:
- 2020-Jan.835
- 2020-Feb.835
- 2020-March.835, and
- 2020-Jan.837
The saved job is stored in a file with extension "job"
Open a Job
Click on "Open Job" to open a previously saved job file. Or, you can use File menu, then "Open Job..." submenu to open a job.Edit a Job
Use File menu, then "Eit Job..." submenu to edit a job.Rename a Job
Use File menu, then "Eit Job..." submenu to edit a job. Click on "Save" button to specifiy the new job name.
Or, you can rename the job file directly. For example, rename "Old.job" file name to "New.job".
Delete a Job
Just delete the job file from your job folder.
Settings
Click on the Setting menu to specify your job folder. The default folder for job files is at:
Documents\Hsu Computing
License
Currently, this is a beta release as of 11/1/2020. It is free to use until 1/1/2021. Any suggestion for new features and improvements are welcome. This product will be subscription based once the beta test expires. The annual subscription fee is to be determined.
Send you suggestion and bug report to support@hsu-computing.com. Or, click the link below:
Help
Send your questions, suggestions, and bug reports to support@hsu-computing.com. Or, click the link below: