Supported File Formats
  • 03 Jun 2024
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Supported File Formats

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Article summary


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 SegmentDefinitionExpected Value
ISA01Author Info Qual00
ISA03Security Info Qual00
ISA05Interchange Sender ID QualZZ
ISA06Interchange Sender ID[Claim.MD Acct #]
ISA07Interchange Receiver ID QualZZ
ISA08Interchange Receiver IDCLAIMMD
GS02Application Sends Code[Claim.MD Acct #]
GS03Application Recs CodeCLAIMMD

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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