HCR 220 Week 8 DQ 1?How are the data elements contained in the HIPAA 837 claim form similar to the CMS-1500, and how does each form relate to the claims process? In your opinion, do the similarities between HIPAA 837 and CMS-1500 complicate or simplify the claims process? Explain your answers. You must proofread your paper. But do not strictly rely on your computers spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper ? in silence and then aloud ? before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes. Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages. Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at ?padding? to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor. The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument. Order Now

 

ADDITIONAL DETAILS 

How are the data elements contained in the HIPAA 837 claim form

Introduction

The HIPAA 837 Claim form is one of the most important documents in healthcare. It contains a comprehensive list of all records and data elements that must be included in a patient’s medical file. However, the HIPAA 837 form is complex, imposing over 8,000 unique fields with over 100 parameters each.

For example, there are over 200 different types of N4 line item segments that may need to be populated for a claim submission. This makes it difficult not only for technicians but also for patient care services like claims processing teams and medical coders who need to create customized reports based on this data…

BHT Segment

The BHT segment is used to indicate the benefit type of the service. It is also used to indicate the benefit type of the procedure, supply and durable medical equipment.

The BHT segment has five parts:

• Benefits Identification Number (BIN) – This is a number that must be provided by a health plan in order for it to identify its benefits program(s). It should be included with each claim submitted by an employer or individual who receives reimbursement from an employee assistance program (EAP), community service provider (CSP) or Certified Disability Management Organization (CDMO). If multiple entities are involved with providing care related to one claim, there will be more than one BIN required on this form so that all parties can be identified through their unique identifiers within your organization’s database system(s).

NM1 Segment

The NM1 segment contains the patient’s name, address and date of birth. It is used to identify the patient and provider. The information in this segment is required by law for all claims submitted to a third party payer (such as Medicare), so it may also be useful for other purposes such as:

• Identifying patients who’ve been treated with certain drugs or devices;

• Tracking payments made by insurers;

• Tracking how much money has been spent on a given service or procedure over time (for example, it can be used for billing purposes).

REF Segment

The REF Segment is a unique identifier used by the insurance company to identify a patient’s claim. It contains information about your health plan, including:

• Your name as it appears on your health plan account (e.g., “Dr. John Smith”)

• Your address and phone number(s), if applicable (e.g., “1234 Main Street 12345”).

This field also provides an opportunity for you to provide additional medical records related to this claim that may be helpful in settling claims with insurers or other parties involved in processing payments due under this arrangement (such as billing offices).

INS Segment

The INS Segment is used to capture the following data elements:

• Claimant’s name and address.

• Type of claim (i.e., emergency room visit) and severity level. For example, “emergency room visit” could be captured as an “Urgent” or “Non-Urgent” claim depending on how severe it was; this would also allow you to differentiate between different types of urgent care visits like Urgent Care vs ER Visits.

It’s important that you use this element when entering information into your form so that it makes sense for each patient.*

N3 Segment

The N3 segment contains information about the patient’s current status. This can include their location, condition, and treatment. It is used in conjunction with the N4 segment, which tracks specific conditions that affect an individual’s health directly or indirectly.

N4 Segment

The N4 segment is the claim payment amount. If a claim is paid more than $50.00, then it must contain this information in the N4 segment. The total amount of your payment will be entered here and listed on Line 12 of your form.

DTP Segment

The DTP segment is a data element that contains information about the date and time of an event.

The data element should be used when there is a need to identify the date and time of an event in order to assist with investigating claims, or as part of an audit trail.

LX Line Item Segment

The LX Line Item Segment is used to inform the payer about the type of service that has been provided. It allows them to know how much money they need to pay and how they can submit a claim or get paid.

For example, if you are requesting reimbursement for an X-ray exam, then this line item segment would read “X-ray.” You should also include your name in this section as well as any additional information you may want added (such as date).

A way to track data in healthcare

The HIPAA 837 claim form is the standard healthcare information form that you may need to submit in order to request payment from your health insurance company. The data elements contained in this form are:

• Beneficiary Identification Number (BIN)

• Claim Type (i.e., medical, surgical, etc.)

• Healthcare Provider Information (HPI)

Conclusion

HIPAA is a complex system, and the 837 form is designed to simplify and streamline claims processing. The form contains all of the necessary data elements needed to process the claim in one place. It’s important to note that each claim will have different content based on what patient information needs are being provided, so it’s best practice for healthcare providers or insurers who are looking at claims data to always consult with their HIPAA compliance professional before deciding what data should be included on an 837 claim form.