ANSI 5010 Response Files

With the change over to ANSI 5010 for electronic claims (835), several insurance companies have discontinued sending any response files that are readable. Instead they are only sending 999 submission acceptance files or more commonly 277CA claim status files. The 999 file tells if the file in total is in the correct format for them to accept. The 277 CA file is generated if the electronic billing file is accepted and tell which claims were accepted or rejected. Both of these files are at best hard to read and very often extremely hard to decifer.

The insurance company EDI departments are telling agencies to contact their software vendor if they cannot read these files. Because of this we made some changes. In the billing module there has been a button to print ANSI files (of all types). We have changed the label to say “Print ANSI 835, 277, 997, 999, RSP.” We have tried our best to print the file in a format that will allow user to understand the files, especially the 277 type files. In order to read and understand the 999 file users will have to print the original 835 electronic billing file to read along side the 999 acceptance file if the file is rejected. We hope these changes will help. Thanks.

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