Zenbridge
EDI Dictionary

EDI 276 Health Care Claim Status Request

This X12 Transaction Set 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.

Segments

Position
Segment
Name
Max use
100
ST
Transaction Set Header
Mandatory
AtMax 1
To indicate the start of a transaction set and to assign a control number
200
BHT
Beginning of Hierarchical Transaction
Mandatory
AtMax 1
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
300
REF
Reference Information
Opt
AtMax 10
To specify identifying information
1000
LOOP
Opt
GT 1
2000
LOOP
Mandatory
GT 1
2200
LOOP
Opt
GT 1
1600
SE
Transaction Set Trailer
Mandatory
AtMax 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

Elements

PositionElementNameRequirementTypeMin/MaxRepeat
1
143
Transaction Set Identifier CodeMandatoryID3/31
2
329
Transaction Set Control NumberMandatoryAlphanumeric4/91
3
1705
Implementation Convention ReferenceOptAlphanumeric1/351