X12 278 Prior Authorization Response Reader
Read X12 278 prior authorization responses without uploading them.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Service 64483
- Denied; HCR A3, reason 0B
- Patient event
- Approved; HCR A1, review AUTH-1, certified 2026-10-01 to 2026-12-29
Result: 1 denied, 0 rejected, 0 pended, 1 approved and 0 other decisions.
Answer the questions this way to reach that result. Your own answers give your own.
Inputs and output
- What you enter
One or more X12 278 005010X217 response files, up to 50 MB each. Files remain in the browser tab.
- What you get
- Denied, rejected, pended, approved and other counts; a denials-first table with raw action and reason codes, review numbers, certified dates, service codes and payer messages; full or redacted CSV downloads.
What this is
For each request and each service in it, it shows the payer's decision, the review or tracking number, the raw reason code, the certified dates and the payer's message.
When to use it
Use this when a payer or clearinghouse returns a 278 response to a prior authorization request, to see at a glance which services were denied, pended or approved and keep the numbers the claim will need.
How this is calculated
Citation
ASC X12 005010X217 278 response as laid out in the CMS esMD X12N 278 companion guide: HCR action, review number and reason per patient event and service, AAA rejections and DTP AAH certified dates. Raw codes only; no X12 code descriptions. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.