EDI Transaction Set

EDI 276: Health Care Claim Status Request

EDI 276 is the X12 Health Care Claim Status Request transaction set, used within Electronic Data Interchange (EDI). This transaction set can be used by a provider, recipient of health care products or services, or their authorized agent to request the status of a health care claim or encounter from a health care payer. This transaction set is not intended to replace the Health Care Claim Transaction Set (837), but rather to occur after the receipt of a claim or encounter information.

What the 276 transaction set covers

Health Care Claim Status Request This X12 Transaction Set contains the format and establishes the data contents of the Health Care Claim Status Request Transaction Set (276) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used by a provider, recipient of health care products or services, or their authorized agent to request the status of a health care claim or encounter from a health care payer. This transaction set is not intended to replace the Health Care Claim Transaction Set (837), but rather to occur after the receipt of a claim or encounter information. The request may occur at the summary or service line detail level.

How Interlink handles the 276

Interlink Commerce maps, transmits, and monitors the 276 for you as part of fully managed EDI — connected straight to your ERP or systems, certified against your retailer’s requirements, and billed only when you trade. Most suppliers go live within 30 days.

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