• Procedures and Resources for Submitting HIPAA-Compliant 837 Claims and Other Healthcare Transactions

    Providers who wish to submit EDI HIPAA-compliant 837 Professional and Institutional claims transactions directly to MassHealth using the Provider Online Service Center, or via the Healthcare transaction services (HTS) -- formerly known as system-to-system billing, must successfully complete testing with MassHealth before submitting production claims. Providers who contract with a billing intermediary or claims clearinghouse must ensure that their billing intermediary or claims clearing house has completed testing with MassHealth. Providers who wish to submit other EDI HIPAA compliant transaction (i.e. 270 or 276) must successfully complete compliance testing with MassHealth before submitting them to the production environment.
  • EDI Testing