After claims are submitted, 340B ESP performs post-submission validation checks to assess the submitted data and determine whether each claim is Conforming or Non-Conforming.
Submission Receipt – Review results immediately after completing a submission.
Claims Data modules – Return to a previous submission and review its overall results.
Claims Details reports – Review and investigate individual claims across submissions.
Note: Claims submitted by a Third-Party Administrator (TPA) using the 340B ESP SDK submission method do not appear in the Claims Data modules. To review SDK-submitted claims, use the applicable Claims Details report in the Reports module.
Submission Receipt
After claims are submitted, the Submission Receipt provides an immediate summary of the claims processed and their validation results.
Use the Submission Receipt to review overall submission metrics, the number of Conforming and Non-Conforming claims, and any Issues or Warnings identified during post-submission validation.
You can also download the submitted claims for your records, including the ESP ID assigned to each processed claim, or save the Submission Receipt as a PDF.
To return to a submission and review its results later, use the applicable Claims Data module.
Learn: For more information about the Submission Receipt, including a detailed breakdown of its components and validation results, see Submission Receipt Overview.
Claims Data Modules
The Claims Data modules provide a submission-level view of claims submitted directly through 340B ESP.
Each row represents a submitted file and provides a high-level summary of the submission, including:
Status – Indicates whether the submission is still processing or has completed processing.
Claims – Displays the number of claims included in the submission.
% Conforming – Shows the percentage of submitted claims that are conforming after processing.
Date – Displays the date the file was submitted to 340B ESP.
Submission statuses include Processing, which indicates that 340B ESP is performing back-end validation checks, and Complete, which indicates that validation is finished and the submission has received its final outcome.
Note: You can rename a submitted claims file from the Submission Summary to make it easier to identify later in the applicable Claims Data module.
Non-Conforming Claims Issue Summary
Selecting a submission opens the Non-Conforming Claims Issue Summary, which provides a breakdown of the validation Issues associated with Non-Conforming claims in the selected submission. Use the summary to identify which validation Issues occurred, how many claims were affected by each Issue, and the percentage of submitted claims associated with each Issue.
Claims may be associated with more than one Issue, so Issue counts may not add up to the total number of submitted claims. Percentages represent the share of claims associated with each Issue type and are not cumulative.
The Issues displayed depend on the submitted claims data and applicable manufacturer requirements.
Claims Details Reports
The Reports module provides a line-level view of previously submitted claims through the applicable Pharmacy Claims Details or Medical Claims Details report.
Each row in a Claims Details report represents an individual claim and includes information about the claim and its validation outcome. Reports can be filtered by information such as submission date, covered entity, validation result, issue type, manufacturer, and product, making it easier to narrow the results and investigate specific claims.
Use these reports to review claim outcomes across multiple submissions, investigate the validation results for an individual claim, identify recurring validation Issues, or review claims associated with a particular covered entity, manufacturer, or product.
Claims Details reports also include claims submitted on behalf of a covered entity through the 340B ESP SDK. Because SDK-submitted claims do not appear in the Claims Data modules, Claims Details reports provide a centralized view of claim-level activity across both direct and TPA submissions.
Using the ESP ID to find a claim
Each processed claim is assigned a unique ESP ID when it is submitted to 340B ESP. The ESP ID remains associated with the claim after submission and can be used to locate the claim in the applicable Claims Details report.
The ESP ID is also included when you download submitted claims data from the Submission Receipt. Keeping a copy of this data allows you to connect de-identified claims displayed in 340B ESP with the corresponding claim records in your local system.
When investigating a specific claim, use the ESP ID to locate the claim in the applicable Claims Details report and review its submission information and validation outcome. This can be especially useful when following up on a previous submission or investigating why a claim was determined to be Conforming or Non-Conforming.
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