Question

Samples of and electronic data interchange transaction include (choose all that apply):

a. a fax copy of the claim
b. CMS Form 1500
c. CMS Form 1450
d. 837 transaction for healthcare claims

Answer 1

The correct example of an Electronic Data Interchange (EDI) transaction for healthcare claims is the 837 transaction. CMS Forms 1500 and 1450 are paper forms, and a fax is a physical document transmission, not an EDI transaction.

Step-by-step explanation:

Examples of an Electronic Data Interchange (EDI) transaction in the context of healthcare can include various forms of electronic claims and documentation. However, not all options provided are correct. Out of the options given: a fax copy of the claim is not an EDI transaction but a physical transmission of a document. CMS Form 1500 is a paper form used for non-institutional providers and suppliers to bill Medicare carriers and durable medical equipment regional carriers.

CMS Form 1450 (UB-04), like CMS Form 1500, is a paper form utilized by institutional providers for claim billing. An 837 transaction is a true example of an EDI transaction used for healthcare claims. It is a standardized format for submitting healthcare claims electronically. Therefore, the correct answer to which are examples of an EDI transaction would be the 837 transaction for healthcare claims. It's important to note that while CMS Forms 1500 and 1450 are related to claims, they are not in themselves EDI transactions unless submitted electronically in an appropriate EDI format.