What is a 277CA?
The 277CA is the claim-level acknowledgment: for each claim in a batch, it says whether the clearinghouse or payer accepted it into processing or rejected it, and why.
ST*277*0001*005010X214~Start of a 277CA claim acknowledgment.BHT*0085*08*277X2140001*20260315*1012*TH~Header: a status report (08), sent as a receipt acknowledgment (TH).TRN*2*CLM00418~Claim one, identified by your patient control number.STC*A7:562:85*20260315*U*412.00~Rejected for invalid information (A7). Status 562 points to the NPI, entity 85 is the billing provider. Action U: rejected.TRN*2*CLM00419~Claim two.STC*A2:20*20260315*WQ*188.00~Accepted into the payer's adjudication system (A2), accepted for processing (20). Action WQ: accepted.REF*1K*2026074A00981~The payer's own claim number. Keep it: it proves the claim was received on time.SE*8*0001~End of the acknowledgment (trimmed for the example).After the 999 confirms that a batch is well formed, the clearinghouse and then the payer check each claim inside it. The 277CA reports what they found, claim by claim.
Accepted is not paid
An accepted claim has only entered the payer’s system. It can still be denied, pended or paid short. What acceptance gives you is proof: the date and the payer’s claim number show the claim arrived within the timely filing limit.
Reading the status
Each claim carries an STC segment with three parts:
- Category code: A1 received, A2 accepted into adjudication, A3 returned as unprocessable, A6 rejected for missing information, A7 rejected for invalid information, A8 rejected for a relational error.
- Status code: what exactly was wrong, such as a member ID, a date of birth or an NPI.
- Entity code: who it was wrong for, such as the billing provider (85), the subscriber (IL) or the patient (QC).
Why rejections slip through
A rejected claim never reached adjudication, so no remittance will ever arrive for it. If nobody reads the 277CA, the claim sits in “submitted” until a follow-up call months later finds the payer has no record of it.
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