Standards & EDI
837 (Health Care Claim)
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
Closing the loop between authorization and claim — same member, provider, service, dates, and reference number — is a core payer data-quality problem. CMS-0057-F's metrics push (approval rates, appeal outcomes) increases the value of clean auth-to-claim linkage for reporting as well as payment accuracy.