837 Electronic Claim
The HIPAA-mandated electronic transaction for submitting professional (837P), institutional (837I), or dental (837D) claims.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 2
- Workspace handoff
- ask d3 →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS HIPAA Administrative Simplification requires the 837 for electronic claim submission. The 837P covers physician practices; 837I covers hospitals; 837D covers dental.
How it shows up in your practice
The clearinghouse translates EHR claim data into 837 syntax. Front-end edits at the clearinghouse should catch missing payer IDs, missing modifiers, and POS errors before submission.
Sources
- CMS — HIPAA Administrative Simplificationhttps://www.cms.gov/regulations-and-guidance/administrative-simplification
- CMS — 835 Electronic Remittance Advicehttps://www.cms.gov/medicare/billing/electronic-billing-edi-transactions/electronic-billing-edi-transactions-process
Look up 837 specifications in Ask D3
Open ask d3 →Related terms
- Denials & Appeals835 Electronic Remittance Advice (ERA)The HIPAA-mandated electronic transaction by which payers communicate payment and adjustment information to providers.
- BillingClearinghouseAn entity that translates electronic transactions between providers and payers and applies front-end edits to reduce rejected claims.
- Denials & AppealsCARC (Claim Adjustment Reason Code)X12-maintained codes communicating why a claim or service line was paid differently than billed.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryClearinghouseAn entity that translates electronic transactions between providers and payers and applies front-end edits to reduce rejected claims.
- Glossary835 Electronic Remittance Advice (ERA)The HIPAA-mandated electronic transaction by which payers communicate payment and adjustment information to providers.
- GlossaryCARC (Claim Adjustment Reason Code)X12-maintained codes communicating why a claim or service line was paid differently than billed.
- GlossaryEFT (Electronic Funds Transfer)The HIPAA-mandated electronic payment transaction that moves funds from payer to provider, paired with the 835 remittance.
- Glossary270/271 Eligibility Inquiry/ResponseThe HIPAA standard EDI transactions used to verify patient insurance eligibility (270 query, 271 response).
- GlossaryCO (Contractual Obligation)An X12 adjustment group code indicating the patient is not responsible because the amount is a contractual write-off.
- GlossaryCoordination of Benefits (COB)The rules and processes that determine which of two or more insurance plans pays first when a patient is covered by multiple plans.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.