277CA in the HIPAA Claim Master
The creation of the 277CA is a feature in the HIPAA Claim Master that has to be licensed and enabled. If you see the menu items for the 277CA disabled, please contact HIPAAsuite's sales department for a quote.
The HIPAA Claim Master allows two mechanism to create the 277CA.
| 1. | When a file is processed and the trading partner is set up to receive the 277CA, then after each claim is parsed from the 837, a 277CA record is created and filled with a standard claim status and status category that is determined in the 277CA setup screen |
| 2. | The claims are exported to the database and a separate process enters values in so-called feed back fields with the results of processing or even adjudication. Then triggered by a query a 277CA record can be created for each claim and packaged into a file to be send back to the claim originator. |
The second method is much more precise since it returns actual process data while the first process has only a canned message to convey.
These feed-back fields can also be used by the HIPAA Claim Status Responder to return the status of a claim by finding it in the claim tables and then reading the status from the feed-back fields.
The feedback fields are included in the scripts to create the EDI_Claims and EDI_ClaimDetail tables but they are commented out. If you open the screen to create the tables and scroll both scripts down to the bottom you will see the commented out area of claim acknowledgment fields.
The feedback fields in the SQL scripts
To create the fields you have to uncomment those rows and then save the script. Then you can click on the button "Compare Scripts with existing Table' and the fields will be added to your data tables.
Now you still have to select those fields. For that you go into the screen to set up the database connection and fields and again scroll to the bottom of the field lists and check all the fields in the Claim Acknowledgment section.
The feed back fields checked so they are included in the processing.
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