Claim edit: Missing billing provider tax ID
Stedi now rejects 837P professional, 837D dental, and 837I institutional claims that don't contain a tax ID for the billing provider.
Billing provider tax IDs
The billing provider is the person or organization, like a clinic or group practice, that will receive payment (if any) for the claim from the payer.
X12 standards require a tax ID for the billing provider on every professional, dental, and institutional claim. The tax ID is either an Employer Identification Number (EIN) or, for an individual provider, a Social Security Number (SSN).
Billing provider tax ID
| Claim type | JSON API field | X12 element |
|---|---|---|
| 837P professional | billing.employerId or billing.ssn | REF02 of Loop 2010AA (Billing Provider Name), where REF01 = "EI" (Employer's Identification Number) or "SY" (Social Security Number) |
| 837D dental | billing.employerId or billing.ssn | REF02 of Loop 2010AA (Billing Provider Name), where REF01 = "EI" (Employer's Identification Number) or "SY" (Social Security Number) |
| 837I institutional | billing.employerId | REF02 of Loop 2010AA (Billing Provider Name), where REF01 = "EI" (Employer's Identification Number) |
How the edit works
If you submit a claim without a tax ID for the billing provider, the payer may reject the claim.
This edit catches the issue before the claim reaches the payer. It prevents payer rejections, which take longer to resolve and delay payment for the provider.
Rejection errors
If you submit a claim using Stedi's Claim Submission API endpoints and the claim fails the edit, you'll get back an error response in real time. The response includes details in the errors array:
{
"errors": [
{
"code": "33",
"description": "Missing Billing Provider Tax Identification Number (TIN). The Tax Identification is a required identifier for the billing provider. Correct and resubmit.",
"followupAction": "Please Correct and Resubmit"
}
]
}If you submit a claim using SFTP and the claim fails the edit, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, and error message:
STC*A6>128*[DATE]*U*[AMOUNT]********Missing Billing Provider Tax Identification Number (TIN). The Tax Identification is a required identifier for the billing provider. Correct and resubmit.~Related claim edits
Stedi has another edit for claims where the billing provider is missing an identifier other than the tax ID. See Claim edit: Missing billing provider identifier.