Follow the claim after submission
After a claim is transmitted, billing staff should verify acceptance and monitor whether it is received, pending, processed, rejected or otherwise requiring action. Payers may provide status through portals, automated systems, clearinghouse tools or electronic claim-status transactions.
276/277 at a glance
The Health Care Claim Status Request (276) and Claim Status Response (277) are electronic transactions used to request and return claim-status information. Billing systems may generate or receive these transactions without the user working directly with the technical transaction format.
A practical follow-up workflow
- Confirm the original claim was accepted into the submission path.
- Check the payer or clearinghouse status after the appropriate processing interval.
- Capture the claim/control/reference number when available.
- Read the status message carefully before taking action.
- Correct and resubmit rejections promptly when supported.
- For adjudicated denials, move into the denial-management workflow rather than repeatedly resubmitting unchanged claims.
- Document dates, actions, reference numbers and next follow-up steps.
Why documentation matters
Good account notes reduce duplicate work and help protect against missed timely-filing or appeal deadlines. A useful note states what was checked, what the payer or clearinghouse reported, what action was taken and what should happen next.
Example account note
Claim status checked in payer portal; claim received and pending. Payer reference captured. No correction requested. Follow up according to payer processing timeframe.
Quick knowledge check
What does a 276 transaction do?
It requests health care claim status information.
Should an adjudicated denial simply be resubmitted unchanged over and over?
No. Review the denial reason and follow the appropriate correction, appeal or other payer process.
What should an account note include?
The status found, date, reference information, action taken and next step.
Module 4 Claims Processing Pack
Open your learner dashboard for the claims workflow reference, pre-submission checklist, rejection practice worksheet and Module 4 assessment.
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