Setting the Optional Segments for the 837 Format

A secondary electronic file adds several new segments to the standard 837 format for primary claims.

These segments are added regardless of how the primary payment is posted:

• Service line payment information (2430 SVD)
• Service line adjustment information (2430 CAS)
• Service line adjudication date (2430 DTP*573)
• Service line approved amount (2400 AMT*AAE)

These segments automatically create based on whether the file type is institutional or professional:

• Claim-level allowed amount (AMT*B6 – institutional only)
• Claim-level payer amount paid (AMT*C4 – institutional, AMT*D-prof)
• Claim-level patient paid amount (AMT*F5 –both)

Payer requirements dictate if other optional segments can be added. You can enable these optional segments with the electronic secondary claim options in the Payer master file.