EDI Support Form EDI Support TypeWhat do you need support with?*What do you need support with? *835 EDI transactions - ERA or EOP+837 EDI transactions - help with submitting claims or rejected claims835 EDI Transactions837 EDI TransactionsName* Business Name* Email Address* NPI Number* Dollar Amount*Date of Payment* MM slash DD slash YYYY Clearinghouse submitting claim to Neighborhood* Payer ID submitted on claim (05047 or 96240)* Member ID* Date of Service* MM slash DD slash YYYY Billed Amount on claim*Date submitted to clearinghouse* MM slash DD slash YYYY Additional details about this issueCAPTCHA PhoneThis field is for validation purposes and should be left unchanged.