MassHealth 
New Charter School Training and Resource 
Guide 
October 13, 2005





•	Requires the Department of Health and Human Services to follow national standards for 
electronic health care transactions and national identifiers for providers, health plans and 
employers.  

•	Addresses the security and privacy of health related data.
 
Guides Available:

Implementation Guide specifies the required data elements.
–	  Available at www.wpc-edi.com/hipaa

Companion Guide outlines MassHealth specific data elements that will be required when submitting 
electronic claims.
–	  Available at www.mass.gov/masshealth





Electronic Transactions

•	837P    Professional Health Care Claim
–	Allows providers to submit direct service claims to MassHealth

•	997  Acknowledgement of receipt

•	835  Health Care Payment and Remittance Advice
–	Assists providers in reconciling their accounts

•	270/271  Eligibility Verification Inquiry and Response
–	Allows providers to verify member eligibility

•	276/277  Claim Status Inquiry and Response
–	Allows providers to check the status of claims