Product: Transaction Manager

Article Link: http://help.truecommerce.com/en/articles/5083010-transaction-manager-how-to-read-a-997-999-functional-acknowledgment

  • Version 5010 HIPAA Transactions

1. Version/Industry Group ID GS08 changes

Message ID

Group Codes

Version 004010/ Industry Identifier

Version 005010/ Industry Identifier

270

HS

004010X092A1

005010X279

271

HB

004010X092A1

005010X279

276

HR

004010X093A1

005010X212

277

HN

004010X093A1

005010X212

278

HI

004010X094A1

005010X217

820

RA

004010X061A1

005010X218

834

BE

004010X095A1

005010X220

835

HP

004010X091A1

005010X221

837Prof

HC

004010X098A1

005010X222

837Inst HC

HC

004010X096A1

005010X223A1

837Dent

HC

004010X097A1

005010X224A1

2. ST03 added

The ST03 element was added to all of the above transactions. This element contains the same value as GS08. Some EDI translation products omit the ISA and GS segments (envelopes) prior to application (ST-SE) processing. By providing the information from GS08 at this level, it will ensure that the appropriate application mapping is used at translation time.

3. 999 Implementation Acknowledgment

The 999 Implementation Acknowledgment transaction is an EDI response message to confirm a file was received and could be properly read by the translator. The 999 can also report on exactly what syntax-related issue caused the errors on the original document. It can notify the sender whether the document was accepted or rejected. While the 999 will acknowledge receipt of the sent document, it does not guarantee that the transaction will be put in use by the business process. For example, just because an acknowledgment is sent does not guarantee a “Claim” will be processed through the adjudication system.

999 Acknowledgment result types:

A – Accepted

R – Rejected

E – Accepted with errors

999 Acknowledgment sample data:

ST*999*0001*005010X231~

AK1*HC*6454*005010X231~

AK2*837*0001*005010X231~

IK3*CLM*120**8~

IK4*2*782*I12*92.511~

IK5*E~

AK9*A*1*1*1~

SE*8*0001~

AK1:

This segment refers to the (GS) group level of the original document

AK101 is equal to GS01 from the original document. For example, for a Claim, AK101= ‘HC’; for an Eligibility Inquiry, AK101 = ‘HS’

AK102 is equal to GS06 from the original document (Group Control Number)

AK103 is equal to GS08 from the original document (EDI Implementation Version)

AK2:

This segment refers to the (ST) Transaction Set level of the document

AK201 is equal to ST01 from the original document. For example, for a Claim, AK201= ‘837’; for an Eligibility Inquiry, AK201 = ‘270’

AK202 is equal to ST02 from the original document (Transaction Set Control Number)

AK203 is equal to ST03 from the original document (EDI Implementation Version)

IK3:

This segment reports errors in a data segment and identifies the location of the data segment

IK301 contains the segment name that has the error. For example, the segment name is ‘CLM’

IK302 contains the numerical count position of this data segment from the start of the transaction set. For example, the erroneous ‘CLM’ segment is in the 120th position

IK303 contains the loop ID where the error occurred.

IK304 contains the error code and it states the specific error. For example, the code ‘8’ states “Segment Has Data Element Errors”

IK4:

This segment reports errors in a data element and identifies the location of the data element

IK401 contains the data element position in the segment that is in error. For example, the error is in position 2; CLM-02

IK402 contains the data element reference number, CLM-02 = ‘782’

IK403 contains the error code and states the specific error. For the example, the code ‘I12’ states “Implementation Pattern Match Failure”; IK404 contains a copy of the bad data element data.

IK5:

This segment reports errors in a transaction set

IK501 indicates states whether the whole document is ‘A’ (Accepted), ‘R’ (Rejected) or ‘E’ (Accepted with errors). Other codes such as ‘M’, ‘W’ or ‘X’ are available but are rarely used (for security decryption purposes). For example, IK501 = ‘E’ that means the claim was accepted with errors

IK502 is not used in the example above

IK506 is to report an error code for the full transaction. IK502 sample error codes include:

1 - Transaction Set Not Supported

2 - Transaction Set Trailer Missing

3 - Transaction Set Control Number in Header and Trailer Do Not Match

Relevant articles:

Accessing Raw EDI

Match a 997 to an 850

How do I find the interchange control number?

Original site referenced: https://officemedicine.com/help/How%20to%20Read%20a%20997%20Acknowledgment.html

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