277CA Claim Acknowledgment

After you submit an 837 claim file, your clearinghouse or payer sends back a 277CA Claim Acknowledgment telling you, claim by claim, whether each one was accepted for processing or rejected. EDI Paisan turns that file into a plain-language Claim Status dashboard so you can see which claims are ready, which need attention, and — on the same screen — work the file as a queue.

What is a 277CA Claim Acknowledgment?

A 277CA (officially "Health Care Claim Acknowledgment," Implementation Guide 005010X214) is the response that follows an 837 submission. For each claim it reports one of:

• ✅ Accepted — the claim passed front-end edits and entered the payer's adjudication system
• ⚠️ Pending — the claim was received but is awaiting information or review
• ❌ Rejected — the claim was returned as unprocessable and never reached the payer

When a 277CA shows rejections, those claims will never come back on an 835 remittance until you correct the problem and resubmit.

277CA vs. 999: A 999 tells you whether your file was structurally valid. A 277CA goes further and tells you whether each individual claim was accepted for processing. You may receive both for a single submission.

Where Do 277CA Files Come From?

You'll receive 277CA files from:

• Clearinghouses (Availity, Change Healthcare, Trizetto, etc.) — usually within minutes to hours of submission
• Payers (Medicare, Medicaid, commercial insurers) — timing varies by payer

Check your clearinghouse portal or SFTP folder for files with names like:

• 277_*.edi
• *_277CA.edi
• *_claimack.edi

The functional group code is HN (GS01) and the version is 005010X214.

Common Rejection Reasons

Reason (Category / Status)	What It Means	How to Fix
A3 / 21	Missing or invalid information	Review the flagged field and correct it
A3 / 33	Subscriber and subscriber ID not found	Verify the member ID from the insurance card
A7 / 509	Missing or invalid billing provider information	Confirm the billing provider NPI and tax ID
A3 / 187	Date(s) of service problem	Check service dates are valid and in range
A7 / 454	Procedure code for services rendered	Verify the CPT/HCPCS code
A6 / 206	National Provider Identifier — missing	Populate the required NPI

---

Using the Claim Status Dashboard

Step 1: Upload Your 277CA File

1. Go to EDI Paisan
2. Click Upload File or drag-and-drop your 277CA file
3. EDI Paisan automatically detects the 277CA and opens the Claim Status dashboard

Guest or Free is enough. You do not need an account to view the dashboard or to use the queue on it.

Step 2: Review the Rollup

At the top of the dashboard, count cards summarize the whole file:

• Total Claims — every claim tracked in the acknowledgment
• Accepted — claims that entered adjudication
• Pending / Warning — claims awaiting information or review
• Rejected — claims returned as unprocessable

Click any card to filter the claim list to just that status. These counts are file truth: marking a claim Worked does not change them.

Step 3: Drill Into a Claim

Each claim card shows the patient control number, patient name, billing provider, charge amount, and a colored status pill. A Next line sits on the collapsed row so you do not have to expand every card to know what to do (Step 4). Expand a claim to see:

• Why — every STC status decoded into plain language, e.g. "A3/21 — Returned as unprocessable: Missing or invalid information"
• Service lines — line-level statuses where the payer returned them
• Reference details — the payer claim control number (ICN/DCN) for accepted claims, service date, and payer
• What to expect — supporting next-step guidance for that claim

Step 4: Work Your Rejections

Filter to Rejected and work the file as a queue. Forty claims with the same bad billing NPI are one setup problem, not forty separate cards.

You still fix the data and resubmit outside EDI Paisan — in your PMS, EHR, or billing system. Success here is a worked queue for this file, in this browser tab.

Grouped, List, search, sort, Worked, Next, and Hide worked are Free, including for guests. They are not behind an upgrade wall. The existing Claim Status Report and CSV stay Pro (Step 6). There is no separate worklist download.

Start here

1. Click Rejected. The list opens in Grouped view, largest group first.
2. Read the Next line on each group — you do not have to expand the pile to know what to do.
3. Open the big group. Fix the shared problem once in your billing system, then resubmit each claim as new.
4. Click Worked on the group when you have done that. Check Hide worked to see what is left.
5. Work one-off rejects the same way, one row at a time.
6. Optionally scan Accepted for payer claim numbers to copy. Next says to keep the number; marking is allowed, not required.

Grouped vs List

Use the Grouped / List control above the list. Switching views does not clear search, sort, or Worked marks.

• Grouped (default on Rejected and Pending / Warning): claims that share the same primary error sit in one pile, largest first. Each pile shows the shared reason in plain language (codes, decoded text, entity, and any payer free text), how many claims in the file share it, and a Next line for the pile. Member cards start collapsed — including a group of one. The header already carries the reason, the count, Next, and Worked.
• List (default on All and Accepted): file order, the way the dashboard used to look. Rejected cards still expand by default. Grouped is one click away — not a second home.

Two claims belong in the same group when they share the same primary error: category code, status code, entity, and the payer's free text. Same codes with different payer text are two groups. A claim rejected only at a service line joins the matching rejected group, not the accepted claims.

The count on a group is file-wide. If search or a rollup filter narrows the pile, the header keeps that total and adds showing M of N.

If a group still mixes outcomes (for example pending and accepted sharing a non-rejected primary), the header says mixed outcome. If only some members have a payer claim number, the header says how many — it does not pick one Next story for the pile. Open the group and read each row.

Search

One search box, over the current filter. Case does not matter. A claim matches if the query appears in any of:

• Patient control number
• Patient name
• Billing provider name
• Payer name
• Payer claim number (ICN)
• Raw or decoded category / status / entity codes
• Payer free text

No matches shows No claims match this search, not the unfiltered list. Search does not look in other files.

Sort

Sort applies after filter and search. There is no A–Z / Z–A toggle.

Control	Order
Group size (largest first)	Default in Grouped
File order	Default in List. Choose this to undo another sort
Status (rejected first)	Rejected, then Pending / Warning, then Accepted
Patient control number	A–Z among claims that have a value; empty / missing last
Patient name	A–Z among claims that have a value; empty / missing last
Charge (high to low)	Largest amount first; missing charge last. Missing is unknown, not $0

Sort does not change which claims are in the file. It does not survive a new file or a closed tab.

Next

Every collapsed group and claim row has a Next line.

Situation	What Next means
Rejected, no payer claim number, one claim	Correct this claim in your billing system and resubmit it as a new claim. The payer has not taken it in.
Rejected, no payer claim number, two or more claims sharing the error	Same error on N claims — likely one setup problem. Fix it once in your billing system, then resubmit each claim as new.
Rejected with a payer claim number	Keep the payer claim number. Do not treat this as "never received" — follow your billing system's replacement or void rules.
Accepted with a payer claim number	Keep the payer claim number. No resubmit. Accepted is not paid — watch for an 835.
Accepted with no payer claim number	No resubmit. Watch for an 835, and record whatever identifiers this file gave you.
Pending / Warning	Review this claim and respond if the status asks for information. Do not resubmit it as new yet.
Group members share a reason but not a next step	Open the group and read each row.

Worked and Hide worked

Worked means you have dealt with this rejection — or recorded this accepted ICN — in your billing system. It is not a change to the 277CA, and it is not a resubmit.

• Mark or unmark one claim with Worked. A marked row shows ✓ Worked.
• Mark or unmark the whole group the same way; that marks or unmarks every member.
• Worked claims stay visible unless you check Hide worked. Showing them again does not unmark them.
• Rollup cards do not change. They remain file truth.
• Under the toolbar, a remaining line reports queue state — for example 2 of 3 rejected remaining. That is not a fifth 277CA total. With Hide worked on, it may add worked rows hidden.
• If you hide everything in this view: All caught up in this view — everything here is marked worked. The counts above still show what is in the file.

This queue is this loaded file in this browser tab. Marks disappear when you load a different file, clear the file, close the tab, or re-upload the same 277CA. Guest and signed-in behave the same. Nothing about this queue is written to an account.

Step 5: Fix Issues in Your Source System

The reasons you see are in EDI terms, but the fix usually needs to happen in your:

• Practice Management System (PMS)
• Electronic Health Record (EHR)
• Billing software
• Claims scrubber

Make the corrections, regenerate your 837, and resubmit to the clearinghouse.

Step 6: Export a Report (Pro)

From the Claim Status Report button you can:

• Print / Save as PDF — a formatted Claim Status Report to share with your billing team
• Export CSV — one row per claim (control number, patient, charge, status, reason codes, payer claim number) for spreadsheet analysis and reconciliation

Viewing the dashboard and working the queue are Free. Downloading or printing the report requires Pro. There is no separate download of groups, next actions, or worked flags.

---

What's Free and what's Pro

On the Claim Status dashboard	Free	Pro
View rollup, expand a claim, decoded reasons	Yes (guest included)	Yes
Grouped / List, search, sort	Yes	Yes
Next on the collapsed row	Yes	Yes
Worked and Hide worked	Yes	Yes
Claim Status Report (print / PDF)	No	Yes
Claim Status CSV	No	Yes
A download of groups, next actions, or worked flags	Not in this release	Not in this release

---

Understanding Claim Status Codes

Status lives in the STC segment as a composite: Category:Status:Entity.

Category Codes (the disposition)

Code	Meaning	Disposition
A1	Acknowledgement / Receipt	✅ Accepted
A2	Acknowledgement / Acceptance into adjudication	✅ Accepted
A3	Returned as unprocessable claim	❌ Rejected
A4	Not found	❌ Rejected
A6	Rejected for missing information	❌ Rejected
A7	Rejected for invalid information	❌ Rejected
A8	Rejected for relational field in error	❌ Rejected
P0–P5	Pending (in process / awaiting info / in review)	⚠️ Pending
R0–R4	Requests for additional information	⚠️ Action needed

Status Codes (the reason)

Code	Meaning
20	Accepted for processing
21	Missing or invalid information
33	Subscriber and subscriber ID not found
187	Date(s) of service
454	Procedure code for services rendered
509	Missing or invalid billing provider information

The full code lists are in the Qualifier Codes reference.

---

Tips for Faster Claim Follow-Up

1. Start with the Rejected filter — those are the only claims that need immediate action. They open Grouped, largest pile first.

2. Read Next before you expand — the next action is on the collapsed row. Expand when you need the Why, the service lines, or the ICN.

3. Fix the big group once — the same rejection across many claims (for example an invalid billing NPI) is usually one setup issue. Mark the group Worked after you have fixed it in your billing system, then Hide worked.

4. Record the payer claim number — accepted claims get an ICN/DCN (REF*1K). Next says to keep it. You will need it for status inquiries and appeals.

5. Don't wait for the 835 — a 277CA rejection means no remittance is coming for that claim. The sooner you correct and resubmit, the sooner you get paid.

6. Accepted ≠ Paid — acceptance means the claim entered adjudication. Payment or denial arrives later in the 835.

7. This queue is this tab — close the tab, load another file, or drop the same 277CA again tomorrow, and the Worked marks are gone. Tomorrow you drop tomorrow's file.

---

Related Documentation

• 277CA File Type Reference — Segment and loop details
• 837 Professional Claims — The claim file a 277CA acknowledges
• 999 Troubleshooting — File-level acknowledgment (structure validation)
• 835 Remittance Advice — The payment that follows an accepted claim

---

Need Help?

If you're stuck on a specific rejection:

1. Check the X12 277 Implementation Guide for field requirements
2. Contact your clearinghouse support for payer-specific rules
3. Reach out to us at [email protected]