Appearance
277CA — Claim Acknowledgment
The 277CA (Health Care Claim Acknowledgment, Implementation Guide 005010X214) is the response a clearinghouse or payer front-end returns after you submit an 837 claim file. It reports, per claim, whether the claim was accepted into adjudication or rejected/returned as unprocessable — and, when rejected, why.
277CA vs. 277: The 277CA is a dedicated acknowledgment transaction (
005010X214). It is different from the 276/277 Claim Status Request/Response pair (005010X212), which is used later in the claim lifecycle to ask "what happened to my claim?" EDI Paisan detects the 277CA specifically and opens a Claim Status dashboard.
Purpose
The 277CA answers the question every biller asks after hitting "submit": did my claim make it through?
It tells you:
- Which claims were accepted into the adjudication system (moving forward)
- Which claims were rejected at the front-end (never reached the payer)
- The reason for each rejection (missing subscriber ID, invalid NPI, bad date, etc.)
- The payer claim control number (ICN/DCN) assigned to accepted claims
- Claims that are pending or need additional information
It flows clearinghouse/payer → provider, typically within minutes to hours of an 837 submission — well before you'd ever see an 835 remittance.
Where the 277CA fits
837 (claim out) ──▶ Clearinghouse / Payer front-end
│
277CA (acknowledgment back) ◀── "accepted or rejected?"
│
(accepted claims continue to adjudication)
│
835 (remittance back) ◀── "paid or denied?"A 999 tells you whether the file was structurally valid. The 277CA goes a step further and tells you whether each individual claim was accepted for processing.
Loop Structure
The 277CA uses hierarchical levels (HL) to nest status information from the payer down to the individual claim and service line:
Loop 2000A — Information Source (HL*20) Payer / clearinghouse
Loop 2100A — Payer Name (NM1*PR)
Loop 2000B — Information Receiver (HL*21) Submitter
Loop 2100B — Information Receiver Name (NM1*41)
Loop 2200B — Receiver Status (TRN, STC, QTY, AMT) Batch-level acknowledgment
Loop 2000C — Billing Provider of Service (HL*19)
Loop 2100C — Billing Provider Name (NM1*85)
Loop 2200C — Provider Summary Status (TRN, STC, QTY, AMT)
Loop 2000D — Patient (HL*PT)
Loop 2100D — Patient Name (NM1*QC)
Loop 2200D — Claim Status Tracking (TRN, STC, REF, DTP)
Loop 2220D — Service Line Status (SVC, STC, REF, DTP)HL Level Codes (277CA)
| HL03 Code | Level | Description |
|---|---|---|
| 20 | Information Source | The payer or clearinghouse returning the acknowledgment |
| 21 | Information Receiver | The submitter the file came from |
| 19 | Provider of Service | The billing provider whose claims are acknowledged |
| PT | Patient | The patient/claim being tracked |
Key Segments
STC — Status Information
The STC segment is the heart of the 277CA. It carries the claim (or service-line) status as a composite code plus supporting detail.
STC*A2:20:PR*20260728*WQ*500~
STC*A3:21:IL*20260728*U*700~| Element | Position | Description | Example |
|---|---|---|---|
| Health Care Claim Status | 01 | Composite: Category:Status:Entity | A2:20:PR |
| Effective Date | 02 | Status date (CCYYMMDD) | 20260728 |
| Action Code | 03 | WQ = Accept, U = Reject | WQ |
| Total Claim Charge | 04 | Submitted charge amount | 500 |
| Claim Payment Amount | 05 | Payment amount (rare at ack) | |
| Secondary Status | 10 | Additional Category:Status:Entity | |
| Tertiary Status | 11 | Additional Category:Status:Entity | |
| Free-Form Text | 12 | Human-readable explanation | Missing subscriber ID |
The STC01 composite is where the meaning lives:
- STC01-1 — Claim Status Category Code (CSCC): the high-level bucket (accepted, rejected, pending)
- STC01-2 — Claim Status Code (CSC): the specific reason
- STC01-3 — Entity Identifier Code: who the status applies to (PR=Payer, IL=Subscriber, 85=Billing Provider)
Claim Status Category Codes (STC01-1)
These determine whether a claim is moving forward or stopped:
| Code | Meaning | Disposition |
|---|---|---|
| A0 | Acknowledgement / Forwarded to another entity | ✅ Accepted |
| A1 | Acknowledgement / Receipt — claim received | ✅ Accepted |
| A2 | Acknowledgement / Acceptance into adjudication system | ✅ Accepted |
| A3 | Acknowledgement / Returned as unprocessable claim | ❌ Rejected |
| A4 | Acknowledgement / Not found | ❌ Rejected |
| A5 | Acknowledgement / Split claim | ⚠️ Review |
| A6 | Acknowledgement / Rejected for missing information | ❌ Rejected |
| A7 | Acknowledgement / Rejected for invalid information | ❌ Rejected |
| A8 | Acknowledgement / Rejected for relational field in error | ❌ Rejected |
| P0–P5 | Pending — in process / awaiting information / in review | ⚠️ Pending |
| F0–F5 | Finalized — adjudicated (payment, denial, revised) | ✅/❌ Final |
| R0–R4 | Requests for additional information | ⚠️ Action needed |
| E0–E4 | Response not possible — error on submitted request | ❌ Rejected |
Claim Status Codes (STC01-2)
Common reason codes returned alongside the category:
| Code | Meaning |
|---|---|
| 19 | Entity acknowledges receipt of claim/encounter |
| 20 | Accepted for processing |
| 21 | Missing or invalid information |
| 33 | Subscriber and subscriber ID not found |
| 35 | Claim/encounter not found |
| 187 | Date(s) of service |
| 206 | National Provider Identifier — missing |
| 454 | Procedure code for services rendered |
| 455 | Diagnosis code |
| 509 | Missing or invalid billing provider information |
| 562 | Entity's National Provider Identifier (NPI) |
A full, authoritative list lives in the Qualifier Codes reference. The tables above cover the codes most commonly seen on a 277CA.
TRN — Trace Number
Links each status back to a specific submission. At the claim level (Loop 2200D), TRN02 carries the patient control number — the same value you put in the original 837 CLM01, so you can match the acknowledgment to your claim.
TRN*2*CLM1001~REF — Payer Claim Control Number
When a claim is accepted, the payer assigns an internal control number (ICN/DCN), returned as REF*1K:
REF*1K*ICN20260001~Keep this number — it's how you'll reference the claim in any future status inquiry or appeal.
QTY / AMT — Batch and Provider Rollups
At the receiver (2200B) and provider (2200C) levels, QTY and AMT summarize counts and dollar totals:
QTY*QA*3~ Accepted claim count
QTY*QC*1~ Rejected claim count
AMT*YU*1500~ Total accepted chargesEDI Paisan Features
Claim Status Dashboard (Free)
When you load a 277CA, EDI Paisan detects it automatically and opens a Claim Status dashboard in place of the raw viewer:
| Feature | What It Shows |
|---|---|
| Accept / Pending / Reject rollup | Count cards for the whole file — click any card to filter |
| Per-claim drill-down | Patient control number, patient name, provider, and charge |
| Why | Every rejection decoded into plain language (A3/21 — Returned as unprocessable: Missing or invalid information) |
| What to expect | Guidance for each claim (accepted → watch for an 835; rejected → correct and resubmit) |
| Service-line status | Line-level STC statuses where present (Loop 2220D) |
| Payer claim numbers | The assigned ICN/DCN for accepted claims |
You can also switch to the standard Tree View to see the full 277CA loop structure with decoded STC elements.
Claim Status Report (Pro)
From the Export menu, generate a printable Claim Status Report or export a Claim Status CSV:
- Print / Save as PDF — a formatted, shareable report of every claim and its status
- CSV Export — one row per claim (control number, patient, charge, status, reason codes, payer claim number) for spreadsheet analysis and worklists
Viewing the dashboard is Free. Downloading or printing the report is a Pro feature.
Example 277CA Structure
ISA*00* *00* *ZZ*CLEARINGHOUSE01*ZZ*SUBMITTER01 *260728*1015*^*00501*000000102*0*P*:~
GS*HN*CLEARINGHOUSE01*SUBMITTER01*20260728*1015*102*X*005010X214~
ST*277*0002*005010X214~
BHT*0085*08*277CA0002*20260728*1015*TH~
HL*1**20*1~
NM1*PR*2*UNITED HEALTHCARE*****46*87726~
HL*2*1*21*1~
NM1*41*2*SUBMITTER CLEARING SVCS*****46*SUBMITTER01~
TRN*2*BATCH20260728B~
STC*A1:19:PR*20260728*WQ*2500~
QTY*90*5~
AMT*YU*2500~
HL*3*2*19*1~
NM1*85*2*RIVERSIDE MEDICAL GROUP*****XX*1234567893~
TRN*1*PROV0002~
STC*A1:19*20260728*WQ*2500~
QTY*QA*2~
QTY*QC*3~
HL*4*3*PT~
NM1*QC*1*DOE*JOHN****MI*A12345678~
TRN*2*CLM2001~
STC*A2:20:PR*20260728*WQ*500~
REF*1K*ICN20260011~
DTP*472*D8*20260710~
HL*6*3*PT~
NM1*QC*1*JONES*MARY****MI*D11223344~
TRN*2*CLM2003~
STC*A3:21:IL*20260728*U*700*0*******Missing or invalid subscriber ID~
DTP*472*D8*20260713~
SE*45*0002~
GE*1*102~
IEA*1*000000102~This example shows:
- A batch of 5 claims from Riverside Medical Group to United Healthcare
CLM2001accepted into adjudication (A2/20), with payer claim numberICN20260011CLM2003rejected (A3/21) — missing/invalid subscriber ID, with free-form text explaining why- Provider-level rollup: 2 accepted (QA), 3 rejected (QC)
Reading a 277CA Like a Pro
Step 1: Check the Rollup
Start with the Claim Status dashboard's count cards. If everything is green (accepted), your batch is moving forward. Any red (rejected) means work to do.
Step 2: Focus on Rejections
Click the Rejected card to filter. These claims never reached the payer — no 835 will ever come back for them until you fix and resubmit.
Step 3: Read the "Why"
Each rejected claim shows its category and status codes decoded. A3/21 means "returned as unprocessable — missing or invalid information"; the entity code (e.g., IL) and any free-form text point to exactly what's wrong.
Step 4: Fix at the Source
Rejections are described in EDI terms, but the fix usually happens in your PMS/EHR/billing system. Correct the underlying data, regenerate the 837, and resubmit.
Step 5: Record Accepted Claim Numbers
For accepted claims, note the payer claim control number (REF*1K). You'll need it for status inquiries (276/277) or appeals.
Common Issues
"Accepted" Doesn't Mean "Paid"
A 277CA acceptance (A1/A2) means the claim was accepted for processing — it entered the adjudication system. Payment or denial comes later, in the 835 remittance. Don't treat a 277CA acceptance as a payment guarantee.
Rejected Claims Have No Payer Claim Number
Because rejected claims never entered adjudication, they won't have a REF*1K ICN. That's expected — there's nothing to reference yet. Fix and resubmit to get one.
Batch vs. Claim Status
The receiver-level (2200B) and provider-level (2200C) STC segments summarize the whole batch or provider. The claim-level status (2200D) is what matters for each individual claim — EDI Paisan surfaces the per-claim status in the dashboard.
Pending Claims
A P-series category (e.g., P1) means the claim was received but is awaiting additional information or review. No action may be required yet — but watch these, as they can turn into requests for information (R-series).
Related Documentation
- Claim Acknowledgment Feature Guide — Using the Claim Status dashboard and report
- 837 Professional Claims — The claim file a 277CA acknowledges
- 999 Troubleshooting — File-level acknowledgment (structure validation)
- 835 Remittance Advice — The payment that follows an accepted claim
- Qualifier Codes Reference — Complete claim status code lookups