Claim Status Request and Response

Providers have a number of options to obtain claim status information from Medicare Administrative Contractors (MACs):

• Providers can enter data via the Interactive Voice Response (IVR) telephone systems operated by the MACs.

• Providers can submit claim status inquiries via the Medicare Administrative Contractors’ provider Internet-based portals.

• Some providers can enter claim status queries via direct data entry screens.

• Providers can send a Health Care Claim Status Request (276 transaction) electronically and receive a Health Care Claim Status Response (277 transaction) back from Medicare.

The electronic 276/277 process is recommended since many providers are able to automatically generate and submit 276 queries as needed, eliminating the need for manual entry of individual queries or calls to a contractor to obtain this information. Submission of 276 queries and issuance of 276 responses should be less expensive for both providers and for Medicare. In addition, the 277 response is designed to enable automatic posting of the status information to patient accounts, again eliminating the need for manual data entry by provider staff members. If unsure whether your software is able to automatically generate 276 queries or to automatically post 277 responses, you should contact your software vendor or billing service.