MassHealth has implemented the mandated HIPAA transaction sets used for electronic claims submission.

As we have successfully transitioned our electronic submitter community to HIPAA Compliant EDI 837 transactions, we have developed a tool set that can be utilized to transition paper based providers to EDI processes. References to HIPAA relating to electronic claims based transactions on the MassHealth web portal are now referred to as EDI, in keeping with industry trends and standards as we move forward.

Questions concerning retail pharmacy claims should be addressed to the Affiliated Computer Systems (ACS) Help Desk at: 1-866-246-8503.

Questions concerning dental claims should be addressed to the Dental Third Party Administrator at 1-800-207-5019.

This information is provided by MassHealth.