If the claim has been denied or rejected, the transaction may include an explanation, such as if the patient is not eligible. If the claim was approved or paid, payment information may also be provided in the 277, such as method, date, amount, etc. If finalized, the transaction indicates the disposition of the claim – rejected, denied, approved for payment or paid. Information provided in a 277 transaction generally indicates where the claim is in process, either as Pending or Finalized. A payer may provide claim status information to a provider using the 277, without receiving a 276.A payer may use a 277 to request additional information about a submitted claim (without a 276).A 277 transaction may be sent in response to a previously received EDI 276 Claim Status Inquiry.The 277 transaction, which has been specified by HIPAA for the submission of claim status information, can be used in one of the following three ways: The EDI 277 Health Care Claim Status Response transaction set is used by healthcare payers (insurance companies, Medicare, etc.) to report on the status of claims ( 837 transactions) previously submitted by providers. List of EDI Transaction Sets and EDI Transaction Codes for Specific IndustriesĮDI 277 Health Care Information Status Notification Specifications.EDI Transaction Set Quick Reference Guide.EDI For Manufacturing And Consumer Goods Manufacturing Solutions.Modernize Your B2B Integration Platform.Integration with Any ERP/Business System.
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