EDI 276/277 — Claim Status Inquiry & Response
The 276/277 transaction pair allows providers to inquire about the status of previously submitted claims and receive updates from payers.
How It Works
276 — Claim Status Inquiry
- Provider sends to payer with: member ID, claim number or date of service, provider NPI, type of service
277 — Claim Status Response
- Payer responds with claim status using standardized claim status category codes and claim status codes
Status Categories
| Category Code | Meaning | Description |
|---|---|---|
| A0-A4 | Acknowledgment | Claim received successfully |
| P0-P4 | Pending | Claim is being processed, awaiting additional information, or in review |
| F0-F2 | Finalized** | Claim has been adjudicated (paid, denied, or adjusted) |
| R0-R5 | Rejected | Claim was rejected before adjudication (data errors, duplicate, etc.) |
Unsolicited 277 (277CA)
The 277CA (Claim Acknowledgment) is an unsolicited version that payers send proactively to confirm receipt of a claim batch. This tells the provider that their 837 submission was received, parsed, and either accepted or rejected at the front-end level — before adjudication begins.
Revenue Cycle Impact
Regular claim status checks are critical for:
- Identifying stuck or pending claims that need follow-up
- Detecting denials early to file corrected claims or appeals within timely filing limits
- Reducing days in accounts receivable (A/R) by proactively managing claim resolution
- Reconciling payments against submitted claims
Most revenue cycle management (RCM) systems automate 276/277 transactions to continuously monitor claim status across all payers.
