EVSpc Version 5010
MassHealth EVSpc and EVScall Software No Longer Available for Download
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 August 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, either, express, implied, statutory or otherwise, including but not limited to, any implied warranties or conditions of satisfactory quality or fitness for a particular purpose.
Please 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.
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. To facilitate the termination of the tool this software has been removed from the site.
All EVSpc and EVScall functionality will be terminated, including the following.
- Support of information storage capability
- 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 impact any of the other options currently available to providers on the POSC or Automated Voice Response (AVR).
The proprietary EVSpc/EVScall software does not currently display key eligibility messages related to MassHealth member’s coverage. It is imperative that providers stop using EVSpc and EVScall immediately and transition to one of the POSC or other access methods below.
- Use Direct Data Entry (DDE)
- Submit a Health Care Benefit Inquiry & Response (270/271) or Health Care Claims Status Inquiry & Response (276/277) batch file transaction, in accordance with MassHealth specifications (requires coordination with the MassHealth Customer Service Center)
- Engage a vendor to generate Health Care Benefit or Claims Status Inquiry batch files
- Check eligibility by calling the Automated Voice Response (AVR) system at 1-800-554-0042
- Submit and receive batched transactions directly (system to system) via HTS (requires coordination with the MassHealth Customer Service Center): NewMMIS Job Aid: Eligibility Verification – Upload Batch Files
Do not wait until the September 1, 2015 date approaches to terminate the use of EVSpc and EVScall. Please take time now to make this very important transition. For questions or assistance with transitioning to one of the access methods, please contact the MassHealth Customer Service Center immediately at 1-800-841-2900 or firstname.lastname@example.org.
The following job aid provides key information on transition options: Eligibility Verification Service Software (EVSpc) Available Transition Options
If you submit batch transactions, please adhere to 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 adhere to the following submission guidelines.
- ONLY check eligibility for those MassHealth members that you will actually service that day or the following day
- DO NOT submit your entire roster of MassHealth members if you are not servicing your entire roster of members that day or the following day
- DO NOT include more than 3,000 members in any single eligibility request
- YOU MUST INCLUDE the member’s Medicaid Identification Number on the eligibility request, if known
- ALWAYS POPULATE all subsequent eligibility requests with the member information received from MassHealth on the prior eligibility response (where applicable)
It is important that you adhere to these file submission guidelines to ensure a timely response to your file submission.
Management Minutes Questionnaires (MMQs)
Effective May 26, 2009, MMQs for nursing facilities must be submitted in a new format. Below are links to the software, specifications, and instructions for submitting MMQs in the new format.
- Download MMQ software file size 3MB
- Specifications for Electronic Submission of MMQ (Appendix D of the Nursing Facility Manual) (PDF)
- Instructions for Completing MMQ (Appendix E of the Nursing Facility Manual) (PDF)
MMIS Trading Partner Testing
The MassHealth Vendor List gives the status of trading partner testing for vendors who are testing HIPAA-compliant claim transactions for MassHealth.