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HIPAA Simplified

Acknowledgements

Acknowledgments identify the workflow status of an EDI transaction. The following ASC X12 transactions are the most common acknowledgments used in health care electronic data interchange workflow.

TA1 Interchange Acknowledgment

The TA1 is used to acknowledge the receipt of an ASC X12 interchange header and trailer pair (ISA/IEA) and to report the technical and syntactical correctness of the ISA/IEA. The TA1 Interchange Acknowledgment is described in the ASC X12 publication X12.5 Interchange Control Structures..

ASC X12C Functional Acknowledgment for Health Care Insurance (997)

ASC X12C Implementation Acknowledgment for Health Care Insurance (999)

This transaction is used to report the syntactical and structural integrity of the functional groups (GS/GE) within a single transmission, and to indicate whether the transmission was accepted or rejected. The Implementation Acknowledgment also reports Implementation Guide conformance (WEDI SNIP Type 1 and 2 errors). The Implementation Acknowledgment should not be used to reject transactions that cannot be processed at the receiver’s application level (for example, invalid codes from external code sets).

ASC X12N Health Care Claim Acknowledgment (277CA)

The transaction acknowledges the validity of an ASC X12N Health Care Claim: Institutional (837I), Professional (837P), or Dental (837D) transaction at the receiver’s application level and informs the submitter whether the claim was accepted for adjudication or rejected.

The ASC X12 Acknowledgement Reference Model provides guidance on the use of health care ASC X12 Acknowledgments.

Visit www.x12.org/products to purchase Technical Reports Type 3 (TR3’s) for the transactions listed above, the X12.5 Interchange Control Structures, and the ASC X12 Acknowledgment Reference Model.

Change Healthcare supports the ASC X12 health care acknowledgments. We strongly recommend that claims submitters accept 277 health care claim level acknowledgments and that payers return functional or implementation acknowledgments and 277 health care claim level acknowledgments.

Standards

Current Version

The Department of Health and Human Services (HHS) has not adopted the ASC X12 health care acknowledgments as HIPAA standards.

To use acknowledgments in conjunction with the current mandated versions (5010) of the HIPAA named transactions, refer to the following Technical Report Type 3 (TR3) specifications listed below. See also the X12 publication entitled Acknowledgment Reference Model available at www.x12.org/products:

ASC X12C/005010X230 Functional Acknowledgment for Health Care Insurance (997).
ASC X12C/005010X31A1 Implementation Acknowledgment for Health Care Insurance (999)
ASC X12N/005010XX214 Health Care Claim Acknowledgment (277CA). Two non-substantive errata are also available.

Next Published Versions

The next anticipated version of the ASC X12C Implementation Acknowledgment for Health Care Insurance (999) transaction and the ASC X12N Health Care Claim Acknowledgment (277CA) will be 7030™. Immediately following publication of 7030^TM,X12 will promote the TR3 to version 8010^TM.

Notes: A 7030™ version of the Functional Acknowledgment for a Health Care Insurance (997) transaction has not been developed. Following the publication of version 8010, X12 will move to an annual release cycle of TR3s. See https://x12.org/about/arc-faq for more information.

See the Change Healthcare Regulatory and Standards Quarterly Update for details concerning the X12 publication schedule.

Anticipated Standard

The next anticipated version of the ASC X12C Implementation Acknowledgment for Health Care Insurance (999) transaction and the ASC X12N Health Care Claim Acknowledgment (277CA) is 7030™.

Note: A 7030™ version of the Functional Acknowledgment for a Health Care Insurance (997) transaction has not been developed.

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