What does a typical Attachments response from the payer look like?

After the CHC clearinghouse sends the attachments and receives the payer acknowledgement, you will receive a response body showing the status of the attachments submission. Results may vary based on payer acceptance or non-acceptance of individual attachment files. Here is an example:

Date format: "yyyy-MM-dd'T'HH:mm'Z'"
 
Sample response:
{
    "transactionDetails": {
        "submitterId": "TESTSBMTR11111",
        "memberId": "0000000001",
        "patientFirstName": "doeone",
        "patientLastName": "johnone",
        "payerId": "TESTEP10",
        "providerId": "1760854442",
        "providerFirstName": null,
        "providerLastName": "happy doctors group",
        "claimStartDate": "2005-05-14",
        "claimEndDate": "2005-05-14",
        "payerName": "VA HEALTH SYSTEM",
        "rejectionInformation": "File type not supported"
    },
    "status": [
        {
            "statusCode": "10",
            "statusMessage": "PARTIALLY_ACCEPTED",
            "statusTimeStamp": "2021-08-20T13:25Z",
            "documents": [
                {
                    "documentName": "rightarm.jpg",
                    "controlNumber": "123456789",
                    "statusCode": "06",
                    "statusMessage": "ACCEPTED_BY_PAYER",
                    "statusTimeStamp": "2021-08-20T13:25Z"
                },
                {
                    "documentName": "rightarm1.jpg",
                    "controlNumber": "123456789",
                    "statusCode": "52",
                    "statusMessage": "REJECTED_BY_PAYER",
                    "statusTimeStamp": "2021-08-20T13:25Z",
                    "rejectionInformation": "File type not supported"
                }
            ]
        }
    ]
}

Time stamp values show both the date and time in a specific format. Each individual attachment file in the submission gets a separate object as part of the overall response. This is how you will find out the state of a partial acceptance of attachments from the payer.

For submissions with more than one attachment, you will receive a Partial Acceptance notification as part of the response should one or more submitted files not be accepted.

Above, you see that accepted attachments will simply receive an acceptance time stamp. Rejected attachments will receive a rejectionInformation field briefly describing the reason.

For a longer set of response examples, see the topic What Other Kinds of Responses can be seen in submissions?.


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