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Technical Report | Health and Medical Sciences | United States of America | Volume 13 Issue 8, August 2024 | Popularity: 4.8 / 10
Date of Service Calculation in 837 Transactions
Praveen Kumar Vutukuri
Abstract: This article aims to better understanding how to calculate final Date of Service in 837 transaction is an electronic file that contains patient claim information. In the Electronic Data Interchange (EDI) process, the "Date of Service" (DOS) refers to the specific date (s) when healthcare services were provided to a patient. The DOS is a crucial piece of information in healthcare EDI transactions, particularly in claims processing (e. g., EDI 837), as it helps insurers and other payers to determine coverage and payment. The DOS is typically found in the service line details of an EDI file, such as the 837 Health Care Claim transaction set. It is usually denoted in segments like DTP (Date/Time Period) with a qualifier indicating the date type (e. g., "472" for Service Date. The DOS must be accurate and validated against other information in the claim, such as patient eligibility and provider contracts, to ensure proper processing.
Keywords: EDI, Electronic Data Interchange, HIPAA, Health Insurance Portability and Accountability Act, Date of Service, DOS, Transaction 837, Service Line, HIP, Health Information Processor, LOB, Line of Business
Edition: Volume 13 Issue 8, August 2024
Pages: 34 - 36
DOI: https://www.doi.org/10.21275/SR24729045601
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