EDI 835 Health Care Claim Payment Advice
This X12 Transaction Set contains the format and establishes the data contents of the Abandoned Property Filings Transaction Set 835 for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set is used to report abandoned property filings information, such as uncashed checks or abandoned bank account balances, to government agencies and may be used by the government agencies to distribute information on abandoned property for publication to the general public. It may also be used to initiate an Electronic Funds Transfer (EFT) payment to transfer the value of the abandoned property to the government agencies.
Segments
Position
Segment
Name
Max use
Mandatory
AtMax 1
To indicate the start of a transaction set and to assign a control number
Mandatory
AtMax 1
To indicate the beginning of a Payment Order/Remittance Advice Transaction Set and total payment amount, or to enable related transfer of funds and/or information from payer to payee to occur
Opt
GT 1
To transmit information in a free-form format, if necessary, for comment or special instruction
Opt
AtMax 1
To uniquely identify a transaction to an application
Opt
AtMax 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
Opt
GT 1
To specify identifying information
Opt
GT 1
To specify pertinent dates and times
1000
LOOP
Mandatory
AtMax 200
2000
LOOP
Mandatory
GT 1
Opt
GT 1
To convey provider level adjustment information for debit or credit transactions such as, accelerated payments, cost report settlements for a fiscal year and timeliness report penalties unrelated to a specific claim or service
Mandatory
AtMax 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)