Sample 997 Functional Acknowledgment

The acknowledgement service creates a functional acknowledgement (997) for inbound messages.

An acknowledgement indicates that an inbound document was received and validated for structure against the appropriate standard. An acknowledgement does not indicate that a document was processed.

The following is the acknowledgement that results from inbound processing of the preceding HIPAA document.

The interchange (ISA) is 106 characters fixed length, but it has been reformatted here to fit on the page.

ISA*00*..........*01*SECRET....*ZZ*RECEIVERS.ID...
*ZZ*SUBMITTERS.ID..*110223*1140*^*00501*000000905*0*T*:~
GS*FA*RECEIVER CODE*SENDER CODE*20110223*1140*1*X*005010~
ST*997*0001~
AK1*HR*1~
AK2*276*0001~
AK5*A~
AK9*A*1*1*1~
SE*6*0001~
GE*1*1~
IEA*1*000000905~

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