277CA Fields

Claim Status

Status of a single claim. Also contains patient, provider and receiver information.

Loop: 2200D

Name	Description	Type	EDI Element
patient	The insured (subscriber) or patient as stated on 837 claim	PartyIDName	NM1 *QC Loop: 2100D
patientControlNumber	Patient control number	String	TRN02
statusInfos	Status infos	List of StatusInfo
payerClaimControlNumber	Payer claim control number	String	REF02 *1K
clearinghouseTraceNumber	Clearinghouse trace number	String	REF02 *D9
billTypeCode	Bill type code	String	REF02 *BLT
serviceDateFrom	Service date for professional or statement date for institutional	Date	DTP03 *472
serviceDateTo	The end date of the service or statement date period. Set to 'serviceDateFrom' if the period is a single date	Date	DTP03 *472
receiver	The Receiver is the entity that expects the response from the Source. Can be a provider, a provider group, a claims clearinghouse, etc.	PartyIDName	NM1 *40 Loop: 2000B
receiverBatchStatus	Receiver batch status	BatchStatus	Loop: 2200B
provider	Billing provider for 277CA	PartyIDName	NM1 *85 Loop: 2100C
providerBatchStatus	Provider batch status	BatchStatus	Loop: 2200C
lineStatuses	Rejected service lines	List of ServiceLineStatus	Loop: 2220D

Service line information and its status

Loop: 2220D

Name	Description	Type	EDI Element
controlNumber	Line item control number from 837	String	REF02 *6R
chargeAmount	Charge amount	Number	SVC02
unitCount	Unit count	Number	SVC07
procedure	Procedure View codes and descriptions	Procedure	SVC01
revenueCode	Revenue code View codes and descriptions	Code	SVC01,SVC04
prescriptionNumber	Prescription number	String	REF02 *XZ
serviceDateFrom	Service period start date	Date	DTP03 472, DTP03 150
serviceDateTo	Service period end date. If not provided in EDI (single day), it is set to 'serviceDateFrom'	Date	DTP03 *151
statusInfos	Status infos	List of StatusInfo

Status Information

Segment: STC

Name	Description	Type	EDI Element
effectiveDate	Effective date	Date	STC02
actionCode	Action code	String	STC03
actionType	Status action type (action code translated to constant/enum)	String	STC03
chargeAmount	Charge amount	Number	STC04
statusCodeInfos	Status code infos	List of StatusCodeInfo	STC01,STC10,STC11
message	Message	String	STC12

Contains sub-elements of the composite healthcare claim status element (STC01,STC10,STC11)

Name	Description	Type	EDI Element
categoryCode	Category code	String	STC01-1
statusCode	Status code	String	STC01-2
entityCode	Entity code	String	STC01-3

Status of multiple claims provided at a provider or a receiver level. At the receiver level, this is a status of all claims in a transaction

Name	Description	Type	EDI Element
traceIdentifier	Transaction control number from 837 for the status at the receiver level. It is a dummy number for the provider-level status; should be ignored.	String	TRN02
statusInfos	Status infos	List of StatusInfo
acceptedQuantity	Accepted quantity	Number	QTY02 *QA
acceptedAmount	Accepted amount	Number	AMT02 *YU
rejectedQuantity	Rejected quantity	Number	QTY02 *QC
rejectedAmount	Rejected amount	Number	AMT02 *YY

Name	Description	Type	EDI Element
entityRole	Entity role View codes and descriptions	String	NM102, N101
entityType	Type of this entity: 'BUSINESS' for organization, 'INDIVIDUAL' for person	String	NM102
identificationType	Identification type, e.g., NPI or EIN. This is a qualifier code translated to a string constant (enum)	String	NM108, N103
identifier	Identifier	String	NM109, N104
lastNameOrOrgName	Organization name or person last name	String	NM103, N102
firstName	First name	String	NM104
middleName	Middle name	String	NM105

Name	Description	Type	EDI Element
code	Healthcare code	String
desc	Code description	String
modifiers	Modifiers	List of Code	SV101-3

Name	Description	Type	EDI Element
code	Healthcare code	String
desc	Code description	String