5010 Acknowledgment File Breakdown


With 5010 claims processing comes two new files, the 999 and the 277CA; these files are created by the payers to provide communication with providers regarding the status of incoming claim files.


When 837 files are submitted, the 999 is provided immediately by CMS systems and those of other payers and is basically an electronic receipt presented to the provider showing that the file was received and is valid.  If the file contains HIPAA syntax errors, detailed information on these errors is provided.


The 277CA is a file supplied a short time later, sometimes the next day.  It shows the status of each claim in the accepted batch.  The results of “front end” edits are included that will show basic errors in claims like invalid policy numbers or duplications.  This file can give you a head start in correcting these errors and resubmitting the claims.


Make sure your medical software vendor can provide you the tools to read these files and include them in your procedural process for verifying the delivery of claims batches and the acceptance of individual claims.

To Learn more please check out our 5010 Acknowledgement Page

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