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EDI 276/277: Claim Status Inquiry and Response

Use the Claim Status Inquiry (276) transaction to inquire about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically.

The Claim Status Response (277) transaction is used to respond to a request inquiry about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically.

Once we return an acknowledgment that a claim has been accepted, it should be available for query as a claim status search. Physicians and other health care professionals can perform claim status (276/277) transactions in batch or real-time mode, based on your connectivity method.

Benefits

  • Electronic claim status transactions may have the following benefits:
  • Increased productivity and efficiency
  • Less time spent on manual, administrative tasks
  • Decreased duplicate claim submissions
  • Improved cash flow
  • Available for participating and non-participating health care professionals

Getting Started

Contact your software vendor or clearinghouse. If available, claim status transactions may be integrated into your Practice Management System or Hospital Information System. This allows systems to automatically generate an inquiry and/or enable automatic posting of the status information to patient accounts.

Many vendors and clearinghouses also offer multi-payer, web-based batch or real-time claim status solutions.

Helpful Resources