837 File Import

The 837 File Import process in SmartCare is the functionality that allows providers to electronically send bills to the MCO for processing and payment. 837 file import refers to the standardized file format that is required to submit a file to SmartCare.

The Process

1. The provider creates an 837 file to submit.

2. The provider logs into SmartCare and imports the file.

3. The system performs three validations of the file before placing the file in the SmartCare system.

4. The system sends an acknowledgement to the provider indicating accepted or rejected.

5. If the file is rejected, the provider uses the acknowledgement to determine the problems and fixes them.

6. Once the file is fixed, the provider re-submits the file.

7. If the file is accepted, the system adds the claims to SmartCare for processing the claims for payment.

A Rejected File or Claims

Refer to The File Validation Process topic for more information about how the file is validated and the types of errors that can be mentioned.

1. If a file is rejected, the acknowledgement is returned to the provider indicating the problems with the file.

2. The provider can fix the claims and resubmit the file.