Electronic Medical Claim

NSF (also known as National Standard Format)

Print Image Format

ANSII 837 Format

Par or Participating Claims

Non-Par or Non-Participating Claims

Claim Acknowledgement Report

Practice Management System

ERA

DME

Electronic Medical Claim:

This term is used for medical claims received in Print Image, NSF, 837 or a proprietary file format. There are many other key words and phrases that are used in describing electronic medical claims and the electronic clearinghouse business including but not limited to the following:

electronic medical claims	electronic claim submissions	electronic claim processing	Medicare electronic claims
Blue Cross electronic claims	Blue Shield electronic claims	Blue Cross Blue Shield electronic claims	BCBS electronic claims
Medicaid electronic claims	electronic claims filing	electronic insurance	medical claims
medical claim	electronic claim filing	electronic claims software	Medisoft electronic claims
electronic claim processing	electronic claims clearing house	National Standard Format	Medicare electronic claim
Aetna electronic claim	United electronic claim	Cigna electronic claim	electronic medical claims processing
electronic insurance claim	electronic claims processor	NEIC electronic claim	electronic health claim
electronic claim clearinghouse	Medicare Part A electronic claim	Medicare Part B electronic claim	insurance coding and electronic claims
free electronic claims	free medical electronic claims	Medicare electronic claim submission	Medicare Part B electronic claim
electronic claims processing software	web md electronic claims	electronic medical claim processing	electronic claims file
electronic claim services	submitting electronic claims	i-Plexus electronic claims	electronic claim form
hipaa electronic claim	secondary electronic claim	secondary electronic claims	electronic claims clearinghouses
837 electronic claim	835 electronic claim	electronic claims and funding	electronic claims service
electronic claims submissions	electronic claims forms	electronic health care claims	national electronic insurance claim
part of a electronic claim	electronic claims to Medicare	claim codes electronics	direct electronic claims
electronic claims clearing	electronic claim specialty	electronic medical claim	paperless claims
electronic 837	electronic 835	electronic forms	electronic hcfa
electronic hcfas	electronic hipaa	electronic clearinghouse	electronic UB92
electronic health insurance	electronic eob	electronic billing	837 claim
electronic paper	electronic health care	electronic cms	electronic 1500
UB92 claim	x12 claim	transaction claim	health insurance claim
NSF claim	electronic form	electronic enrollment	UB claim
health care claim	electronic processing	ANSI claim	EOB claim
Medicare claim	electronic filing	CMS claim	and electronic software
electronic medical claim submission	electronic remittance	UB04

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NSF (also known as National Standard Format):

This applies to any nationally standardized data format, but it is often used in a more limited way to designate the Professional EMC NSF, a 320-byte flat file record format used to submit professional claims. Click here to view sample

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Print Image Format:

This refers to the HCFA-1500 (12-90) or (08-05) version print image (which is a computer file that looks like a filled-in claim form minus the form. Click here to view sample

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ANSII 837 Format:

This refers to the HIPAA compliant version of the medical claim. There are many versions published for this format. Click here to view sample

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Par or Participating Claims:

This typically means that a provider is registered and credentialed with a particular health plan. In the clearinghouse industry, the term Par can mean that the clearinghouse gets reimbursed a small amount of money per claim from the payer.

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Non-Par or Non-Participating Claims:

This typically means that a provider is not registered and is not credentialed with a particular health plan or payer. In the clearinghouse industry, the term Non-Par can mean that the clearinghouse does not get reimbursed for claims submitted to this payer.

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Claim Acknowledgement Report:

This refers to various reports that clearinghouses and payers provide to acknowledge the receipt of claim files.

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Practice Management System:

This refers to the software or web based system a provider uses to enter patient demographics and charges.

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ERA:

This stands for Electronic Remittance Advise and i-Plexus receives these transactions and translates them into Explanation of Benefits which is what the provider is used to receiving in the mail. Click here to view sample

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DME:

This refers to Durable Medical Equipment and i-Plexus does handle this type of claim.

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