Health Care Implementation Acknowledgment (999)/ Health Care Claim Acknowledgment (277)


Worker's Compensation

Minnesota

State Farm® Worker's Compensation will create the following electronic acknowledgment transactions that must be exchanged as per the state of Minnesota mandate.

Uniform Standard Companion Guide for Implementation Acknowledgment for Health Care Insurance – ASC X12N 999 (5010X0231A1)
Uniform Standard Companion Guide for Health Care Claim Acknowledgment ASC X12N 277 (005010X214)


Other Mandated States

State Farm Worker's Compensation will create the following electronic acknowledgment transactions that must be exchanged as per various state mandates.

Implementation Acknowledgment for Health Care Insurance – ASC X12N 999 (5010X0231A1)
Health Care Claim Acknowledgment - ASC X12N 277 (005010X214)


Non-Mandated States

State Farm Worker's Compensations voluntarily creates electronic acknowledgments for all other non-mandated states. The following electronic acknowledgment transactions are created.

Implementation Acknowledgment for Health Care Insurance – ASC X12N 999 (5010X0231A1)
Health Care Claim Acknowledgment - ASC X12N 277 (005010X214)




Auto

Minnesota

State Farm Auto will create the following electronic acknowledgment transactions that must be exchanged as per the state of Minnesota mandate.

Uniform Standard Companion Guide for Implementation Acknowledgment for Health Care Insurance – ASC X12N 999 (5010X0231A1)
Uniform Standard Companion Guide for Health Care Claim Acknowledgment ASC X12N 277 (005010X214)


Non-Mandated States

State Farm Auto voluntarily creates electronic acknowledgments for all non-mandated states.  The following electronic acknowledgment transactions are created.

Implementation Acknowledgment for Health Care Insurance – ASC X12N 999 (5010X0231A1)
Health Care Claim Acknowledgment - ASC X12N 277 (005010X214)


Receiving Electronic Implementation and Claim Acknowledgments

State Farm Auto and State Farm Worker's Compensation use a connection with the Utah Health Information Network (UHIN) to make the electronic acknowledgment transactions available for retrieval.

Providers and Electronic Data Exchange (EDI) clearinghouses can contact UHIN for information on how to retrieve the electronic acknowledgments. If you are currently sending electronic medical bills to State Farm, then your acknowledgments are being made available for retrieval through UHIN.

If you have received your acknowledgments and have a question regarding the rejection reason received in one of them then you can contact the patient’s State Farm claim representative.  If you have not received your acknowledgments and your clearinghouse has told you State Farm has not made the acknowledgments available for the bills you have sent, then you can send an email to our B2B Support Team, HOME.SYS-EDI-EFT.722n00@statefarm.com.


Utah Health Information Network (UHIN)

Contact UHIN at 801-466-7705 ext 200 for receiving electronic acknowledgments

The State Farm UHIN Trading Partner number is: HT005054-001.