Health Care Claim Status Response
The HIPAA X12 277 is the payer's answer to a 276, reporting where a claim stands in adjudication.
In this guide
277 Claim Status Response moves from Payer to Provider / Clearinghouse (Payer → Provider) via AS2, SFTP, API, Clearinghouse. The interactive diagram below traces every business and technical step the message passes through — press Play Flow to watch it travel, or click any step for detail.
How it works
How 277 Claim Status Response Works
Sender
Payer
Receiver
Provider / Clearinghouse
Direction
Payer → Provider
Standard
ANSI ASC X12
Version
005010X212
Transport
AS2 / SFTP / API / Clearinghouse
Business Purpose
Healthcare
Sender — Payer
EDI Transmission
277
Health Care Claim Status Response
ANSI ASC X12 005010X212
Receiver — Provider / Clearinghouse
Related transaction flows
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Ask EDI AI →277 Claim Status Response workflow. Steps: Receive 276 Request, Adjudication Lookup, Generate 277 Response, Return via Clearinghouse, Billing System Receives, Route to Work Queue. Transmitted from Payer to Provider / Clearinghouse via AS2, SFTP, API, Clearinghouse, following ANSI ASC X12 005010X212.
Overview
Gives billing teams actionable status categories (received, pending, finalized/payment, finalized/denial) to prioritize follow-up work.
Sender
Payer
Receiver
Provider / Clearinghouse
Direction
Payer → Provider
Standard / Version
ANSI ASC X12 005010X212
Segment structure
Key segments that make up this transaction set:
| Segment | Name | Purpose |
|---|---|---|
| STC | Status Information | Category and status codes describing the claim's current state. |
| REF | Reference Identification | Payer's claim control number. |
| DTP | Date or Time Period | Relevant status or payment date. |
Interactive example
Click any segment below to see its business meaning.
ST
This is an envelope or control segment. Select a highlighted segment on the left (shown in green) for a full business explanation.
View raw EDI
ST*277*0001*005010X212~
BHT*0010*08*STAT-8821*20230920*0931~
HL*1**20*1~
NM1*PR*2*Acme Health Plan*****PI*66783~
HL*2*1*21*1~
NM1*41*2*Riverside Medical Group*****46*1932837465~
HL*3*2*19*1~
NM1*1P*2*Riverside Medical Group*****XX*1932837465~
HL*4*3*22*0~
NM1*IL*1*DOE*JANE****MI*W123456789~
STC*F1:139*20230918**478.00~
REF*1K*CLM-556210~
SE*11*0001~Mapping example
A representative field-level mapping from a common source system into this transaction:
| Source | Source Field | Target Field |
|---|---|---|
| Payer Claims Adjudication System | claim.status_category | STC01 (first component) |
| Payer Claims Adjudication System | claim.paid_amount | STC04 (Monetary Amount) |
Validation rules
- STC01 must use valid Health Care Claim Status Category and Status Code combinations from the HIPAA code lists.
- REF02 (payer claim number) should be echoed from the original 276 or newly assigned if this is the first response.
Common errors & troubleshooting
Billing team misinterprets a 'pending' status as denied
Cause: Category code (e.g., P1 = Pending) was mapped to a generic 'action required' bucket in the practice management system.
Fix: Maintain a full crosswalk of STC category/status codes to internal work-queue categories, distinguishing pending from denied.
Frequently asked questions
No — a 277 reports the claim's current status at the time of the request, which can still change as adjudication continues.
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