This Draft Standard for Trial Use contains the format and establishes the data contents of the Health Care Claim Status Request Transaction Set (276) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used by a provider, recipient of health care products or services, or their authorized agent to request the status of a health care claim or encounter from a health care payer. This transaction set is not intended to replace the Health Care Claim Transaction Set (837), but rather to occur after the receipt of a claim or encounter information. The request may occur at the summary or service line detail level.
To indicate the start of a transaction set and to assign a control number
To define the business hierarchical structure of the transaction set and identify the business application purpose and reference data; i.e., number, date, and time
To specify identifying numbers.
To supply the full name of an individual or organizational entity
To specify additional names or those longer than 35 characters in length
To specify the location of the named party
To specify the geographic place of the named party
To specify identifying numbers.
To identify a person or office to whom administrative communications should be directed
To identify dependencies among and the content of hierarchically related groups of data segments.
To record claim information specific to the primary insured and the insurance carrier for that insured
To supply patient information
To supply demographic information
To supply the full name of an individual or organizational entity
To specify the location of the named party
To specify the geographic place of the named party
To identify a person or office to whom administrative communications should be directed
To uniquely identify a transaction to an application.
To specify identifying numbers.
To indicate the total monetary amount.
To specify any or all of a date, a time, or a time period
To supply payment and control information to a provider for a particular service
To specify identifying numbers.
To specify any or all of a date, a time, or a time period
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments).
