What are the 276 and 277 transactions?

Most claims are paid without anyone asking about them. The rest need follow-up, and the 276/277 pair lets a billing team ask a payer about a claim electronically instead of waiting on hold.

What the answer tells you

The 277 response uses category codes that map onto the next move:

• P codes, pending: the claim is in process. Check again later.
• F codes, finalized: F1 paid, F2 denied, and other final states. A denial without a remittance should be worked like any other denial.
• R codes, requests: the payer needs something, such as medical records or information from the patient.
• A4, not found: the payer has no record of the claim. Resend it with proof of timely filing.

When to ask

Asking too early wastes a transaction; asking too late wastes the filing window. A good rule is to check once a claim has gone past the payer’s usual time to pay, then on the date the payer’s own answer suggests. Not every payer supports the 276, and some answer only through their portal or by phone, so a status follow-up process needs a fallback for each.

277 or 277CA?

Same transaction family, different job. The 277CA acknowledges a claim once, right after it is submitted. The 277 answers a status question at any point afterwards.