General Definitions
- = Enrollment not Required
for Transaction Set
- = Enrollment Required
- SEC = Secondary Production
- ACK = Acknowledgement Level Report(s) Available as dictated by Payer
- CLR = Claim Level Report(s) Available as dictated by Payer
- 277 = Unsolicited, payer will return a 277 in response to an 837 without a 276 claim
status request
- PLR = Provider Level Report(s) Available as dictated by Payer
SOP Definitions
- COM = Commercial
- CAR = Medicare
- CAD = Medicaid
- BLU = Blue Cross / Blue Shield
- CHP = Champus
SSI Payer ID
SSI Payer ID to be used by Client's to properly route claims
Payer Health Plan ID
Payer's ID that is written on claim for proper routing at Payer
Billing Claim Status
- = Claim Status Expected
- = Claim Status
Conditional
- = Claim Status Not Expected