835 4010 Forms
The 835 4010 form provides for all the many repetitions of levels within the transaction. It also handles the 835 “application document” as the entire transaction from ST-SE.
The 835 form consists of three tabs, holding information for these sections:
§ Header – segments from ST to the 2000 loop.
§ Claim Payments – segments in the 2000 loop.
§ Provider Adjustments – PLB segments.
Finding Errors on the Header Tab