In today's medical billing world, paper billing forms have been replaced by electronic documents defined by ANSI, the American National Standards Institute. In healthcare applications, ANSI-837 data formatting is used by clearing houses in the process of coordinating billing and payments back and forth between hospitals and insurance companies. The hospital or clearing house sends an 837 transaction, and the insurance company sends back an 835 payment remittance. These transactions are a national standard. They are designed for speed and ultra compact data sizes. With their ease of availability, and comprehensive list of fields, 837 files have become a very attractive source for managers and data miners in the medical claim data world.
But there’s a down side. ANSI-837 files are no where near easy to understand. You basically have to be a Guru to work with them on any level. A person looking to extract information from an 837 file will quickly discover that parsing tools are costly and have a large learning curve. And what if you need to massage the data in any way? You’ll find out that off-the-shelf parsers don’t offer that. They convert data, but that’s all. Some companies selling parsing software also offer services where they will set up the conversion structure for you, pretty neat! But this too is expensive.
Wouldn’t it be cool if you could find a company out there that is entrenched in the ANSI-837 world, filled with Gurus and parsing tools, crunching 837’s as a daily routine, but NOT because they’re in the business of selling data conversion. That’s what you need! That company would be able to offer a MUCH more cost effective solution.
Think of it this way:
Say you need to find a way to hook up your old VCR to your new HDMI television. You’re about to do an internet search for a professional, but you look out the window and happen to notice that the cable guy is doing an install at your neighbor’s house. You approach him, and in the end you walk away with a $0.20 connector, just because he had 50 of them in his truck.
Along comes System13! For almost two decades System13 has been processing thousands of 837 files daily. Not only that. System13 had to overcome the reality that all those clearing house vendors out there don’t exactly interpret the ANSI-837 standards the same way. I know, because I’m one of the programmers here at System13. Writing an 837 parser is a requirement and a rite of passage for our programmers. We’ve written multiple 837 parsers and writers, from scratch, and in different languages, with features ranging from crosswalks to total obfuscation. We developed these tools to make our own lives easier in this ANSI-837 processing world that surrounds us.
All that said to say this: If you are needing some ANSI-837 data extraction of some kind, give System13 a call. We don’t sell 837 conversion software, but we do that work every day. We’ll save you the cost of purchasing software, the headache of learning about ANSI-837’s, and we’ll just hand you back the data you want, in the format you need!
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John Coogan is a Senior Data Analyst and 23 year veteran of System13.