Example 02

In the following example, ABC Payer (Electronic transmitter ID number S00002) submitted an 837 PACDR Professional claim file with an Originator Application Transaction Identifier of 2020131052389 in BHT03 directly to State Encounter System (Electronic transmitter ID number STATE01) on January 31, 2019. The file contained 3 claims with a total charges of $800.00. This file was transmitted after the cutoff time for same day processing, so State Encounter System processed the file on February 1, 2019 and notified ABC Payer on February 1, 2019 that their file was rejected as they have not completed the trading partner enrollment process, therefore, they are not a valid trading partner with State Encounter System. Please note that the 277 data reporting acknowledgment is immediately terminated and no additional hierarchical levels are sent/acknowledged.