X12 HIPAA 277 Response Transmission

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. 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:

• A 277 transaction may be sent in response to a previously received EDI 276 Claim Status Inquiry
• A payer may use a 277 to request additional information about a submitted claim (without a 276)
• A payer may provide claim status information to a provider using the 277, without receiving a 276

Information provided in a 277 transaction generally indicates where the claim is in process, either as Pending or Finalized. If finalized, the transaction indicates the disposition of the claim – rejected, denied, approved for payment or paid. If the claim was approved or paid, payment information may also be provided in the 277, such as method, date, amount, etc. If the claim has been denied or rejected, the transaction may include an explanation, such as if the patient is not eligible. 

X12 HIPAA 277 Specification

X12 HIPAA 277 specification is available at:

• EdiNation

X12 HIPAA 277 Code Example

X12 HIPAA 277 code example is available at:

• EDI Tools for .NET X12 HIPAA 277 parse & generate C# example

X12 HIPAA 277 Sample File

ISA*00*          *00*          *ZZ*1234567        *ZZ*11111          *170508*1141*^*00501*000000101*1*P*:~
GS*HC*XXXXXXX*XXXXX*20170617*1741*101*X*005010X212~
ST*277*0001*005010X212~
BHT*0010*08*277X212*20050916*0810*DG~
HL*1**20*1~
NM1*PR*2*ABC INSURANCE*****PI*12345~
HL*2*1*21*1~
NM1*41*2*XYZ SERVICE*****46*X67E~
HL*3*2*19*1~
NM1*1P*2*HOME HOSPITAL*****XX*1666666661~
HL*4*3*22*0~
NM1*IL*1*SMITH*FRED****MI*123456789A~
TRN*2*ABCXYZ1~
STC*P3:317*20050913**8513.88~
REF*1K*05347006051~
REF*BLT*111~
REF*EJ*SM123456~
DTP*472*RD8*20050831-20050906~
HL*5*3*22*0~
NM1*IL*1*JONES*MARY****MI*234567890A~
TRN*2*ABCXYZ2~
STC*F0:3*20050915**7599*7599~
REF*1K*0529675341~
REF*BLT*111~
REF*EJ*JO234567~
DTP*472*RD8*20050731-20050809~
HL*6*2*19*1~
NM1*1P*2*HOME HOSPITAL PHYSICIANS*****XX*1666666666~
HL*7*6*22*1~
NM1*IL*1*MANN*JOHN****MI*345678901~
HL*8*7*23~
NM1*QC*1*MANN*JOSEPH~
TRN*2*ABCXYC3~
STC*F2:88:QC*20050612**150*0~
REF*1K*051681010827~
REF*EJ*MA345678~
SVC*HC:99203*150*0****1~
STC*F2:88:QC*20050612~
DTP*472*D8*20050501~
SE*38*0001~
GE*1*101~
IEA*1*000000101~