New EDI Service Offering for the Part A/FQHC/HHH 276/277 Claim Status Inquiry and Response

National Government Services is pleased to announce the availability of a ‘near’ real time response to claim status inquiries submitted to EDI with the 276 claims status inquiry transaction. NGS expects to implement this service on 1/13/2020. Trading partners who wish to take advantage of this new service need to do nothing more than ensure the 276 claim status inquiry files are formatted with one inquiry per transaction (ST-SE). The file can contain multiple transactions (ST-SE) with one inquiry. The NGS EDI processes will recognize the format of the file and route the individual inquiries through the new real time flow and return the 277 claim status response file to the trading partner mailbox within minutes of receipt of the correctly formatted 276 Request.

Claim status inquiry files that contain more than one inquiry per transaction will continue to be routed through the current batch processing and the 277 claim status response file returned to the trading partner’s mailbox the next business day.

Please note that the near real time process will run during the existing claim system availability on regular business days and the process will not be available on weekends and holidays. Files eligible for the near real time process received during off hours will be held and processed when the systems become available.

Posted 1/8/2020