5010 Acknowledgement Software

An essential component of the transition to ANSI 5010 claim processing is the confirmation of clean and compliant claim files sent by the provider to the payer. This applies to both the testing process and actual production claims.

New transaction standards have been developed for this purpose and are included with the new ANSI 5010 transaction sets. They are two new files, the ANSI 999 batch file confirmation and the 277CA unsolicited claim status report.

ANSI 999 Batch File Confirmation

The 999 is a receipt provided by most payer systems that confirms that a file was received and is HIPAA compliant. It is normally provided within minutes of the submission of the ANSI file by the provider. If there are problems with the file that caused it to be rejected, the 999 will provide the details necessary to determine how to identify them. This tool is vital in conforming with and passing the testing process with your payer or clearinghouse and communicating issues to your vendor.

277-CA Claim Status

The 277-CA is provided after front end processing has been performed by the payer. It provides detailed information at the claim level regarding the acceptance or rejection of individual claims. It replaces older confirmation reports provided under the 4010 standard.

These two reports allow a provider to confirm that a batch was accepted and that individual claims have been processed. If either process fails, they can immediately correct the issues and resubmit the batches or claims.

Now MedTranDirect provides a parser that can read, display and print the information in both of these files so that you can work your way through the testing process confident that your claim files can pass 5010 testing and production processing. If you have issues in this area, this product can identify the problems for your staff or your vendor. Once you move into production, the MTD Parser can provide a vital confirmation at the batch and claim level every time these files are exchanged. The product is web-based and requires no installation. Try it for free and see how this valuable tool can provide the missing pieces to your HIPAA compliance strategy.