Acknowledgements

If a transaction is structurally sound, and all errors within the transaction occur at the claim level, or below, then the claim, or claims in error are rejected and the valid claims are accepted. A 997 and/or 999 indicating accepted with errors is generated for the transaction with the value E, for the Transaction Acknowledgement Code, AK501/IK501.

If the AK501/IK501 is showing a status of "E", it indicates that the transaction set has claim level errors, but if there is only 1 transaction set in the Functional Group, then the AK901 status is set to "E" (Accepted, but errors noted).

The results of Claim Level Rejection are reported in the 5010X214 277 Claims Acknowledgement, 277CA. By default, reporting of the transaction details is at the Provider Level. This behavior can be changed to report at the claim level if the Clm_Lev_Rej_Level parameter is set to C to indicate claim.

Note: The 227CA is not generated for any non-837 input data.

If there are no errors in the HIPAA EDI 837 data, then 277CA reporting only goes to the Provider Level regardless of the setting of the Clm_Lev_Rej_Level parameter. The results on the 277 Claims Acknowledgement Report do not appear in the Translated Acknowledgement Report.