Claim status inquiry (276 / 277)

Outcome

You can send a 276 to ask the payer where a claim sits, read the 277 response, and act on the answer (resubmit, follow-up, escalate, write-off).

Prerequisites

Scope	What it lets you do
billing.claim.read	View the claim
billing.claim-status.write	Send 276s

A trading partner with 276/277 capability for the payer; otherwise you'll need to call / portal.

When to send 276

Don't send a 276:

• Before the payer's stated SLA elapses (clearinghouses 14d typically; direct payers 30+).
• For claims that aren't ACCEPTED (the payer can't tell you about a claim it hasn't received).

Steps

1. Open the claim. Click Send 276. The platform builds the X12 276 (005010X212) referencing the claim's payer claim control number and the member's IDs.

2. The 276 sends to the trading partner that handles 276/277 for the payer. Submission appears on the Submission tab.

3. The 277 response lands within the partner's SLA — usually minutes to hours. The Submission tab updates with the 277 inspect view.

4. Read the 277. The STC segment carries the status:

   STC01	Meaning
   A0	Acknowledged.
   A1	Acknowledged for processing.
   F0	Finalized.
   F1	Finalized — payment in process.
   F2	Finalized — denial.
   F3	Finalized — payment forwarded to another payer.
   F4	Finalized — split.
   P0–P5	Pending various reasons.
   R0–R*	Rejected various.
   D0	Data search unsuccessful (not on file).

5. Act on the answer:

   Status family	Move
   F0–F4	Reconcile against the 835; if no 835 yet, expect it shortly.
   P*	Set follow-up; payer is reviewing.
   R* / D0	Resubmit; the claim isn't where you thought.

Bulk 276 sweep

For an aging cohort (e.g. payer X, accepted 30+ days, no 835):

1. Filter on /ar/aging to the cohort.

2. Bulk select, Send 276. The platform sends in batch (one 276 file with multiple claim references).

3. Watch the dashboard's 276 responses today widget. Triage as 277 responses arrive.

When the partner doesn't support 276

Some smaller payers / partners only do real-time portal lookups. The fallback is to call / portal-check; the platform records your inquiry-and-response on the Communication tab.

Validation

Check	Expected
276 transaction writes on the Submission tab	Yes.
277 response renders structured (STC + DTM segments)	Yes.
Bulk 276 produces one file with multiple claim refs	Yes.
Manual portal lookup logs on Communication	Yes (manual entry).

Troubleshooting

Symptom	Cause	Fix
277 says D0 "not on file"	Claim never reached the payer	Resubmit; check routing.
277 stuck P* for weeks	Payer's review queue	Escalate; sometimes a phone call to the payer's provider line works.
276 fails with partner_not_capable	Partner can't do 276	Tenant Manual → Trading partners.
Bulk 276 returns mixed responses	Each claim in different state	Triage per response.

Where to next

• 6.5 — Follow-up cadence — managing the follow-up dates the 277 sets.
• 3.2 — Track acks — refresher on the whole ack ladder.