EVSpc Version 5010

MassHealth EVSpc/EVScall

Will be Terminated on 9/1/2015–
Is No Longer Available for Download

Reminder―MassHealth will terminate the use of its proprietary Eligibility Verification Software (EVSpc\EVScall) on Tuesday, September 1, 2015, and will not provide support for the software tool after that date. Additionally, any transaction submitted to MassHealth via the EVSpc or EVScall software after that date will be rejected.

The proprietary EVSpc/EVScall software does not currently display key eligibility messages related to a MassHealth member’s coverage. It is imperative that providers stop using EVSpc and EVScall immediately and transition to the POSC or one of the other access methods.

Important Information—All MassHealth providers were notified on August 18, 2014, to stop using EVSpc to verify member eligibility, as the software tool does not provide eligibility notifications, warnings, and other important messages about MassHealth members that are provided by other MassHealth eligibility access methods noted below. Pursuant to that notification, you must transition to one of the eligibility verification methods available on the POSC or via Automated Voice Response (AVR). If you continue to use the software tool, EOHHS is not responsible for any action or inaction taken based on the information or lack of information provided by this tool, and will not be liable to you or any third party for any consequential, indirect, incidental, reliance, or special damages including, but not limited to, lost profits, even if EOHHS has been advised of the possibility of such damages. To the maximum extent permitted by applicable law, EOHHS disclaims all warranties, conditions, representations, or guaranties of any kind—express, implied, statutory, or otherwise, including but not limited to, any implied warranties or conditions of satisfactory quality or fitness for a particular purpose.

The following functionality will be terminated.

Note: ALL EVSpc and EVScall functionality will be terminated on September 1, 2015, including the following.

  • Support of information storage  
  • Submission of Health Care Benefit Inquiry & Response (270/271) transactions, via batch or real-time transactions
  • Submission of Health Care Claims Status Inquiry & Response (276/277) transactions, via batch or real-time transactions

Please note that the termination of the EVSpc/EVScall software does not affect any of the other options currently available to providers on the POSC or AVR.  

If you submit batch transactions, please follow the important eligibility submission guidelines below.

To ensure timely and efficient processing of transactions submitted by MassHealth providers and vendors in conformance with Phase I CORE 155: Eligibility and Benefits Batch Response Time Rules, and in accordance with HIPAA ASC X12 and MassHealth policy, providers and vendors must follow the following submission guidelines.

  1. ONLY check eligibility for those MassHealth members to whom you will actually provide service on that day or the following day.
  2. DO NOT submit your entire roster of MassHealth members unless you are providing services for your entire roster of members that day or the following day.
  3. DO NOT include more than 3,000 member requests in an eligibility batch-file request.
  4. DO NOT include more than 3,000 member requests in an eligibility transaction.  The 270/271 HIPAA Implementation Guide requires that the 270 transaction contain no more than 99 patient requests when using the transaction in batch mode though it allows other patient request limits to be set.  MassHealth agrees to the reasonable limit of up to a 3,000-member request per transaction and will reject transactions exceeding this limit beginning on May 10, 2015.  MassHealth reserves the right to modify this limit as required, in accordance with the HIPAA standard.  
  5. YOU MUST INCLUDE the member’s Medicaid Identification Number on the eligibility request, if known.
  6. POPULATE ALL subsequent eligibility requests with the member information received from MassHealth on the prior eligibility response, where applicable.

It is important that you follow these file submission guidelines to ensure a timely response to your file submission.

Visit www.mass.gov for more information about how to transition to another eligibility verification method, or contact the MassHealth Customer Service Center at 1-800-841-2900 to discuss transition options.