X12 835 CLP Segment Guide: Fields, Format, and Testing Gotchas

Jul 27, 2026 · 6 min read

The CLP segment is where the 835 stops being an envelope and starts being an answer. It tells your posting engine what was billed, what got paid, what the patient owes, and whether the payer even accepted the claim in the first place. Get one field wrong in a test file and you can watch an auto-posting job silently misapply a payment.

Quick answer

CLP is the Claim Payment Information segment inside each Loop 2100 of an X12 835. It carries the claim-level summary: your internal claim identifier, the payer's adjudication status, the amount you originally billed, the amount the payer actually paid, and how much responsibility got shifted to the patient. Every claim reported in the remittance gets exactly one CLP segment, and everything underneath it (CAS adjustments, SVC service lines) ties back to the values it establishes.

The elements that actually matter in practice

CLP01 →

Patient Control Number — echoes the claim identifier your system originally submitted on the 837 — this is your join key for reconciliation

CLP02 →

Claim Status Code — a short numeric code telling you whether the claim was paid as primary, paid as secondary, denied, or reversed

CLP03 →

Total Claim Charge Amount — what was originally billed, before any adjustments or discounts

CLP04 →

Claim Payment Amount — what the payer is actually remitting for this claim on this transaction

CLP05 →

Patient Responsibility Amount — copay, coinsurance, and deductible amounts shifted to the patient — often ends up on a statement

CLP07 →

Payer Claim Control Number — the payer's internal claim ID, needed if you ever have to call or resubmit

Example

Synthetic example Generated by Synthibase

CLP*PAT29817*1*450.00*360.00*45.00*12*993820011477*11*1*

A synthetic CLP for a claim billed at $450, paid as primary, with $360 remitted and $45 shifted to patient responsibility.

Where this trips people up

Teams building test files for the first time tend to assume CLP03 minus CLP04 always equals CLP05, but that math only holds when there are no contractual write-offs. In real remittances, the difference between billed and paid is frequently split between patient responsibility (CLP05) and adjustment amounts reported later in CAS segments — leave CAS out of a synthetic test file and your reconciliation logic will flag a phantom balance every time.

→

EDI 835 Remittance Advice: Complete Guide for Healthcare IT

→

How to Test 835 Remittance Reconciliation Before Go-Live

Generate realistic CLP test data in seconds

Synthibase produces fully synthetic 835 files with correctly balanced CLP amounts, CAS adjustments, and status codes — so your reconciliation logic gets tested against edge cases, not just the happy path.

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This page is written independently by Synthibase for testing and informational purposes. It is not an official publication of HL7 International or X12/Washington Publishing Company, and is not a substitute for reviewing the official standard or your trading partner's companion guide. See our Terms of Service for full legal terms.