Neither the new 277U Claim status nor the X12N 824 IGs are final, much less mandated transactions. However, that does not mean they can't be used. These acknowledgment transactions are not covered by the rule so anything goes. For that matter, a payer could deny a claim for no eligibility and send out a postcard as notification. The transaction/claim was accepted but did not process far enough to warrant a notice of financial adjudication (i.e. 835).
The 837 does not have a direct response transaction like the 270/271, 276/277, 278/278 or NCPDP do. If the 835 were a paired transaction with the 837 things would be easier. There is a relationship but it is not one for one and it is not absolute. This also seems to be the consensus of both TG2 WG5 (276/277) and TG8 SPWG1 (X12N 824 IG) which I call into fairly regularly. But I have been known to get things wrong before. >>> "Michael Mattias/Tal Systems" <[EMAIL PROTECTED]> 05/06/02 09:56AM >>> ----- Original Message ----- From: Robert Barclay <[EMAIL PROTECTED]> Just a warning about 837s. Even if the 837 claim passes the TA1/997/824 gauntlet it could still be rejected by a 277 Front End Acknowledgment before reaching an 835. The billing should expect a response to all 837 claims submitted but the 835 is not the only transactions that can do this, even after acceptance into the adjudication system. Has "Unsolicited Claim Status" (Front end edit) been mandated or defined yet? Last time I saw this (maybe a month ago) the IG "Health Care Payer Unsolicited Claim Status (edit report), ASC X12N 003070X070 (possibly to be replaced by 004020X030)" was not yet available at the WPC site,and the HCFA/CMS regulations had not yes defined this as a 'covered transaction.' Did I miss something? Michael Mattias Tal Systems, Inc. Racine WI [EMAIL PROTECTED]
