Nebraska Medicaid Program

Electronic Data Interchange (EDI)

EDI Trading Partner Reports

Claim Reports For EDI Trading Partners - Testing

PDF Electronic Claim Activity (ECA) Report – Rejected Claims

PDF Electronic Claim Activity (ECA) Report – Deleted Claims

Codes Used on Electronic Reports

Nebraska Medicaid uses national codes for reporting on the electronic remittance advice and other reports. Click here Washington Publishing Company (WPC) HIPAA Code List to connect to the web site where national codes are maintained.

  • Medicaid Remittance Advice uses “Claim Adjustment Reason Codes” and “Remittance Advice Remark Codes.”
  • Medicaid Deleted Claims and Medicaid Electronic Claim Activity (ECA) reports use: “Claim Status Codes” and “Claim Status Category Codes.”

277 Claims Acknowledgment
 
The HIPAA 5010 277 Claims Acknowledgment Transaction is an acknowledgment of receipt of claim submission(s) at the pre-processing stage; which is the process that determines whether or not to introduce the claim into the MMIS adjudication system. Claims will be reported back to the Trading Partner as either ‘accepted’ or ‘rejected’.
The 277 Claims Acknowledgment Transaction may report at the Information Receiver Level, Provider Level, Claim Level and Line level, providing the following information:

  • Reports total claims accepted and total claims rejected.
  • Reports total accepted billed amounts and total rejected billed amounts.
  • Claims that have been accepted are reported with the assigned MMIS claim number.
  • Claims that have been rejected are reported with a HIPAA X12 Claim Status Category Code and Claim Status Code(s). Up to 3 may be reported for a claim.
  • Service line information is included when a service line causes the rejection of a claim.

 

Medicaid EDI Help Desk

866-498-4357 (toll free) or 471-9461 (in Lincoln)

 

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