Assemble the 276 transaction: ISA/GS envelope, ST*276 segment, BHT segment with purpose code '13' (status request), Loop 2000A/2000B payer and submitter loops, Loop 2000D/2200D service provider and claim level loops with patient control number and total claim charge
Include the original claim's ICN or payer claim number in REF segments (REF*1K for payer claim number) to allow the payer to locate the specific claim
Submit via your clearinghouse API or SFTP batch path; for real-time 276, use a clearinghouse that exposes a synchronous endpoint and check the response immediately
In the 277 response, locate STC segments in Loop 2200D: STC01-1 is the health care claim status category code, STC01-2 is the claim status code; reference the X12 277 code set to classify (e.g., category A1 = acknowledged, F0 = finalized/paid)
If STC01-1 begins with 'P' (pending) record the date in STC03 and schedule a re-inquiry; if 'F' (finalized) pull the adjudication detail and reconcile against your AR
Capture TRN segments to correlate the 277 response back to the original 276 inquiry for audit trail
Known gotchas
Some payers return a 277CA (claim acknowledgment) in place of a 277 status response; these are structurally different transactions — validate the transaction set ID (ST01) before parsing
The claim status code set is maintained by X12 and versioned; codes differ between 005010X212 (276/277) and 005010X214 (277CA) — load the correct companion guide for the payer
Batch 276s submitted over SFTP may have a turnaround of hours; design your poller to handle asynchronous responses rather than expecting an immediate reply
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claude mcp add --transport http waymark https://mcp.waymark.network/mcp