What is an EDI 277-A1 Health Care Claim Status Notification?
One of the X12 EDI transactions, EDI 277-A1 conveys information regarding the status of a healthcare claim. This transaction set can either be used as an electronic response to a previously received EDI 276-A1 or to request additional information without a submitted claim. The EDI 277 transaction set is normally used by healthcare payers such as insurance companies, Medicare and more.
EDI X12 277-A1 Health Care Information Status Notification Sample
An EDI 277-A1 document is divided into functional groups that explain the contents of the transaction being conducted. A sample EDI 277-A1 document looks like this[1].
ISA*00* *00* *ZZ*SENDER *ZZ*RECEIVER *130924*0936*^*00501*000039422*0*P*~
GS*HN* SENDER *00000003B*20130924*0936*39421*X*005010X212~
ST*277*0001*005010X212~
BHT*0010*08*277005010X212E2*20130924*0536*DG~
HL*1**20*1~
NM1*PR*2*SAN FRANCISCO HEALTH PLAN*****PI*170558746~
PER*IC*EDI OPERATIONS*TE*8888808699*EX*4042*FX*6179235555~
HL*2*1*21*1~
NM1*41*1 A GOOD HOSPITAL *****46*1234567890~
HL*3*2*19*1~
NM1*1P*1*THE HOSPITAL*****XX*9876543210~
HL*4*3*22*0~
NM1*IL*1*DOE*JANE****MI*12345678901~
TRN*2*406ba0b7-700d-4c99-8c75-6da5adaf1da4~
STC*F1~65*20130924**1090*20.08*20130902**20130902*619524~
REF*1K*3239A7MW~
REF*EJ*61157208-000~
DTP*472*RD8*20130819-20130819~
SVC*HC~36415*25*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~80051*96*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~80076*101*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~82565*58*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~82947*66*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~84520*58*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~85025*92*20.08****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~85652*50*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SVC*HC~74020*544*0****1~
STC*P1~104*20130924~
DTP*472*RD8*20130819-20130819~
SE*44*0001~
GE*1*39421~
IEA*1*000039422~
Workflow for the Exchange of an EDI 277-A1 Health Care Information Status Notification
The EDI 277-A1 transaction set is used by healthcare service providers to provide claim information to a provider, recipient, or an authorized agent. A typical EDI 277-A1 document states if the claim is pending or finalized.
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[1] https://www.sfhp.org/files/providers/edi/SFHP_276-277CompanionGuide_20160128.pdf