Implementation of the Health Care Claim Status Inquiry and Response (276/277) Version 005010 - Part B Shared System Change
The purpose of this Change Request (CR) is to provide the Multi Carrier
System (MCS) maintainer with requirements to prepare the MCS system to process the health care claim
status inquiry and response transactions. MCS shall receive inquiry files which contain the fully edited
version 005010 of the CMS defined flat file record as documented in the attached layout. The Shared
System Maintainer (SSM) shall prepare the outbound flat file for transmission to the A/B MAC with the
appropriate data content defined in the outbound claim status response definition. Furthermore, the contents
of the outbound file shall be fully compliant with the Healthcare Claim Status Inquiry and Response
(276/277) Technical Report Type 3 (TR3), including the appropriate claim status category and claim status
code list requirements.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 24, 2009
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