Supported File Formats
- 21 Jun 2024
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Supported File Formats
- Updated on 21 Jun 2024
- 1 Minute to read
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- DarkLight
- PDF
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Note
A maximum of 10,000 claims will be accepted in any one file, regardless of the file format. Any claim data sent beyond this quantity will not be processed. To submit more thank 10k claims, split the claim data into multiple files.
ANSI X12 (837)
Supported ANSI X12 file formats:
- 837P = Professional Claims
- 837I = Institutional Claims
- 837D = Dental Claims
Companion Guide
| X12 Segment | Definition | Expected Value |
|---|---|---|
| ISA01 | Author Info Qual | 00 |
| ISA03 | Security Info Qual | 00 |
| ISA05 | Interchange Sender ID Qual | ZZ |
| ISA06 | Interchange Sender ID | [Claim.MD Acct #] |
| ISA07 | Interchange Receiver ID Qual | ZZ |
| ISA08 | Interchange Receiver ID | CLAIMMD |
| GS02 | Application Sends Code | [Claim.MD Acct #] |
| GS03 | Application Recs Code | CLAIMMD |
Single Line Claim File (XLS/CSV)
Spreadsheet claim format, with all claim data and procedures on a single row. Format is CSV (Comma Separated Values) or XLS (Office Excel 97)
Multi-line Claim File (XLSX)
Spreadsheet claim format, with a separate row per procedure. Format is XLSX (Excel 2007)
XML Claim File (XML)
XML claim format
JSON Claim File (JSON)
JSON claim format
Batch Eligibility (CSV)
Spreadsheet batch eligibility file. Results must be viewed individually.
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