Concepts

The 277 Claim Status response is built from request/response data in the EDI_ClaimStatusHeader and EDI_ClaimStatusDetail tables and a pair of Source tables that can be filled from the HIPAA Claim Master or built from the HIPAA Claim Status Responder and filled externally.

Claim Master as Source

Every row in EDI_Claims represents a single claim and every row in EDI_ClaimDetail represents a billable event or instance. The Claim Master stores all data pertaining to a claim. The Claim Master can also store Claim Status information under the fields labeled as "Claim Feedback" in the HIPAA Claim Master Database Connection Fields nodes and Claims and ClaimDetail table creation scripts. Since the HIPAA Claim Master already fills in all of the Claim information, the "Claim Feedback" fields are all that is necessary to provide a Claim Status on a claim. These fields are:

Claim Status Source Tables

If the HIPAA Claim Master tables cannot be used, the HIPAA Claim Status Responder provides scripts for an independent set of information source tables which contain all fields necessary to provide Claim Status information. The EDI_ClaimStatusSourceHeader is to be used to store information about a specific claim; a claim's line items are stored in EDI_ClaimStatusSourceDetailI.