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997 REPORT

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NOTE: This varies from carrier to carrier. This is from NHIC.

 

The next level of editing produces the Functional Acknowledgement Transaction Set (the 997 Report). The 997 Report indicates the results of the syntactical analysis of the transaction. It informs the office whether a batch of claims (file) that were received by CABBS had been accepted or rejected. The 997 report is usually delivered to the CABBS mailbox the next business day after the file was submitted. The purpose of this report is to provide end-to-end acknowledgement of a document/transaction receipt. An acknowledged transaction can be:

 

Accepted

Rejected

Accepted with error(s)

 

Partially accepted (some transaction sets were accepted, others were rejected)

 

The 997 Report is a technical report that is mostly used by billing agencies, clearing houses, and software vendors. It is the responsibility of each office to ensure that either the office, their clearing house, or their software vendor has the capability to interpret their 997 Acknowledgement Reports and correct any errors that occur.

 

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