Home Encounter Data Improvement Resources Understanding error responses

Understanding error responses

May 2023

This resource is an educational and reference tool covering the technical aspects of encounter data error communication. In collaboration with HICE, health plans and provider organizations gathered to explore and demonstrate industry resources and tools available to address tracing errors to their sources.

Author

IHA in partnership with the Health Industry Collaboration Effort (HICE) Encounters Standardization Team

Why use it

Errors in encounter data cause delays in delivering the encounter to the destination. Understanding error response file structure and content can help you quickly find and address encounters that require correction and resubmission. Share this resource to help your organization to better understand the X12 file interchange process between the transmitted 837 claim files and their associated response files.

Who it’s for

This resource is intended for primarily delegated provider organizations (managed services organizations, provider practices, and independent physician associations) that submit encounter data.

Key take-aways

The resource provides an overview and details about various error response files, such as the TA1, 999, and 277 files. Details include:

  • What each error response file means and how to pinpoint the cause of the issue
  • How to review the status of the claim/encounter based on the file contents
  • Examples for each file type and how to interpret the file
  • Checklist to determine what the error response files mean

Have edits or additions for this resource? Please let us know.

IHA’s Resource Hub is made possible through a grant from Health Net, LLC’s Encounter Data Improvement Program.

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