Providers who wish to submit EDI HIPAA-compliant 837 Professional and Institutional claims transactions directly to MassHealth using the Provider Online Service Center (POSC), or via one of the MassHealth Connectivity submissions methods, 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. If you do not know if your vendor/intermediary is approved to submit EDI claims to MassHealth, or are considering using a vendor for billing purposes, please view the vendor list below, which provides a current status of approved MassHealth vendors and the type of transactions the vendor supports (for example, coordination of benefits claims as well as void and replace transactions).
This list was not created for endorsement purposes, but rather to assist providers in identifying vendors who support HIPAA-compliant claim transactions with MassHealth.
The following resources will help you prepare to process HIPAA 837 batch transactions with MassHealth.
- Procedures for submitting HIPAA-compliant 837 claims
- MassHealth specifications addenda
- Vendor List (PDF)
- MassHealth Trading Partner Agreement - April 2005 (PDF) file size 1MB
- EDI Testing FAQ
If you have questions after viewing the material listed above, please Contact MassHealth Customer Service via e-mail at firstname.lastname@example.org or by phone at 1-800-841-2900 for assistance before or during the testing process.
This information is provided by MassHealth .