WEDI, a nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange and a statutory advisor to the U.S. Department of Health and Human Services (HHS), announced the development of an industry issue brief to provide guidance and information on some basic misunderstandings related to acknowledgements within HIPAA transaction exchange using the ASC X12 Version 005010 (5010). 

In a recent industry Acknowledgement survey WEDI issued, the need for such an educational resource was identified.The 8-page document is a high-level explanation of the acknowledgement transactions, in which it addresses the following topics:

• What is the Acknowledgment Reference Model (ARM)?
• What acknowledgments are currently mandated?
• What is the purpose of the TA1, Interchange Acknowledgment?
• What is the proper use of the 999, Implementation Acknowledgment?
  • Why is the 999 not required for the 835?
  • Why the 999 instead of 997?
• What is the proper use of the 277CA, Claim Acknowledgment?
• What is the difference between the unsolicited (u277) and the claims acknowledgment (277CA)?
• If an acknowledgment reason cannot be codified, how do you request new claim status code?
• If an acknowledgment claim category status code cannot be identified, how do you request a new category code?

Download the full Acknowledgements Issue Brief here.

For more information on WEDI’s industry efforts surrounding Acknowledgements, please visit the WEDI Acknowledgements Subworkgroup page.