276/277 HIPAA Transaction Notes (Washington State Health Care Authority)
276/277 HIPAA transaction guides state that when the trading partner submits the 276 request by any one of the specified methods the 276 request will be validated using EDI validator (up to levels HIPAA validation level 1 & 2), translated and will be processed. The positive outcome will be the 277 response. Negative outcomes will result in negative TA1 and/or 999 transactions.
Trading partners can send the 276 request [both Real time and Batch] using HTTP MIME Multipart. Trading partners can send the 276 request [both Real time and Batch] using SOAP WSDL.
If the test file generates a negative TA1 or negative 999 acknowledgments, then the submission is unsuccessful and the file is rejected. The trading partner needs to resolve all the errors that are reported on the negative TA1 or negative 999 and resubmit the file for test. Trading partners will continue to test in the testing environment until they receive a positive TA1 and positive 999. Receipt of a positive TA1 and 999 transaction is considered successful testing. Trading partners are allowed to submit production files once they successfully completed testing.
Communication Protocol Specifications
Trading partners can submit HIPAA transactions to Health Care Authority using the following four methods:
- Secure File Transfer Protocol (SFTP)
- ProviderOne Web Portal
- Hypertext Transfer protocol (HTTP MIME + Multipart)
- Simple Object Access Protocol (SOAP + WSDL)
Washington State Medicaid requires every trading partner to have a valid login credentials to submit 276/277 transaction through all four submission methods available. If you have forgotten your login credentials (login id and password) please email to have this information reset. Health Care Authority limits a file size to 50 MB while uploading HIPAA files through the ProviderOne web portal and 100 MB through FTP. Below are the applicable claim status search options 1. Billing Provider NPI, Claim Number (TCN) 2. Billing Provider NPI, Client ID, Date of Service