X12 837 Healthcare Claim Explained
The X12 837 is the standard used to submit healthcare claims from a provider to a payer (insurance company) in the United States, mandated under HIPAA for electronic claim submission. This guide explains its variants, structure, and how to read one — with a note on the sensitive data it contains.
What Is an X12 837 File?
The 837 Healthcare Claim transaction set carries everything a payer needs to process and reimburse a claim: patient and provider identification, diagnosis and procedure codes, service dates, and charges. It comes in three variants for different care settings: 837P (Professional — physician office visits), 837I (Institutional — hospital/facility claims), and 837D (Dental). The payer processes the claim and responds with an 835 Remittance Advice detailing what was paid, denied, or adjusted.
Key Segments in an 837
- BHT (Beginning of Hierarchical Transaction) — sets the transaction's purpose and reference date.
- NM1 (Individual or Organizational Name) loop — identifies the billing provider, subscriber, and patient.
- CLM (Claim Information) — the claim ID, total charge amount, and facility/frequency codes.
- HI (Health Care Information Codes) — diagnosis codes (ICD-10) supporting the claim.
- SV1/SV2 (Professional/Institutional Service line) — one per billed service: procedure code, charge amount, units.
A Worked Example
BHT*0019*00*0001*20240115*0930*CH~ NM1*85*2*ACME MEDICAL GROUP*****XX*1234567890~ CLM*CLAIM0001*250.00***11:B:1*Y*A*Y*Y~ HI*ABK:M25561~ SV1*HC:99213*150.00*UN*1***1~
Read left to right: claim CLAIM0001 from billing provider Acme Medical Group, total charge $250.00, place of service code 11 (office), diagnosis code M25.561, and a service line for procedure code 99213 billed at $150.00.
Handling PHI Responsibly
An 837 file contains Protected Health Information (PHI) — patient names, diagnosis codes, and identifiers subject to HIPAA. This converter processes every file entirely inside your own browser; nothing is ever uploaded to a server, which is precisely why it's suitable for reviewing sensitive claim data without a business associate agreement or server-side data handling risk. See Security & Privacy for the full technical explanation of local-only processing.
Converting an 837 to a Spreadsheet
To turn an 837 file into a readable table, use Convert X12 837 to CSV or Convert X12 837 to Excel — every BHT, NM1, CLM, HI, and SV1/SV2 segment is labeled automatically.
Try It Yourself
Load a sample 837 file instantly on the converter and see every segment labeled, with export to CSV, Excel, or JSON — processed entirely on your device.
Open the Free EDI ConverterFrequently Asked Questions
What is the difference between 837P, 837I, and 837D?
837P is for professional (physician office) claims, 837I for institutional (hospital/facility) claims, and 837D for dental claims. All three share the same underlying transaction set structure with setting-specific segments.
What responds to an 837 claim?
The payer processes the claim and returns an 835 Remittance Advice detailing what was paid, denied, or adjusted.
Is it safe to upload an 837 file containing PHI to an online tool?
This converter never uploads your file anywhere — parsing happens entirely in your browser, so no PHI ever leaves your device.