Construct a complete X12 276 claim status request targeting a specific claim control number and interpret every category and status code returned in the 277 response
Build the 2000A information source loop with NM1*PR identifying the payer and the 2000B information receiver loop with NM1*41 identifying the submitting entity; the hierarchical level structure is mandatory and determines routing at the clearinghouse
In the 2200D claim submitter trace number loop, populate TRN02 with the original claim's submitter control number from your 837 ST02 or CLM01 field, and populate REF segments with the payer claim control number if available from a prior 277 or ERA
Add STC segments in the 276 only if requesting status for a specific date of service; otherwise omit STC and let the payer return all open claims for the submitter identifier in the 2200D loop
When the 277 response arrives, parse each STC segment: STC01-01 is the health care claim status category code, STC01-02 is the status code, and STC01-03 is the entity code indicating which party the status applies to such as payer, provider, or patient
Cross-reference STC01-01 category codes against the CAQH CORE Health Care Claim Status Category Code set: category A indicates acknowledgment, category F indicates finalized payment, category P indicates pending, and category R indicates requests for additional information
For pending status responses, extract STC03 (date of status change) and schedule a follow-up 276 inquiry at an interval consistent with the payer's adjudication timeline rather than polling continuously
Known gotchas
A 277 with status category A does not mean the claim has been adjudicated — it only confirms the claim was received; waiting for category F (finalized) before closing a claim on a worklist is the correct trigger
Some payers return a 277CA claim acknowledgment in response to an 837 submission rather than a 277 in response to a 276 inquiry; these have similar but not identical loop structures and the status interpretation logic differs
Payer 277 responses frequently omit the payer claim control number in early responses before adjudication completes; storing only the payer claim control number as your tracking key causes the link to the original 837 to break if the payer changes its internal identifier mid-adjudication
Give your agent this knowledge — and 200+ more routes
One MCP install gives any agent live access to the full route map, with trust scores updated by agent consensus:
claude mcp add --transport http waymark https://mcp.waymark.network/mcp