Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.mass.gov/dma	

		MassHealth
		All Provider Bulletin 127
		October 2003

	TO:	All Providers Participating in MassHealth

	FROM:	Beth Waldman, Acting Commissioner

	RE:	Implementation of HIPAA-Compliant Electronic Remittance Advice 

New Electronic 		On October 16, 2003, the Division of Medical Assistance (Division) Remittance Advice 		implemented the HIPAA-compliant 835 health care remittance advice
Format and 	and payment transaction.  MassHealth providers who opt to receive this 
Specifications	transaction will be issued their first 835 at approximately the end of October.  Our Companion Guide for this transaction should be used in conjunction with the 835 Implementation Guide.  It can be downloaded from our provider Web site at http://www.mahealthweb.com (click on “HIPAA” and then “HIPAA Testing” to reach the guide).  The Companion Guide contains MassHealth-specific technical and data element instructions.  

If you are a retail pharmacy provider, please see the related information on page 2 of this bulletin.

Requirements	All MassHealth trading partners must sign a Trading Partner Agreement 
	(TPA) before receiving 835 transactions.  You must complete a MassHealth 
	TPA (attached), only if you have not already done so, and return it to the
	address below.
		MassHealth  
		ATTN:  HIPAA Support Center
		P.O. Box 9101
		Somerville, MA  02145

Trading Partner 		You will also be asked to complete a Trading Partner Profile (TPP) 
Profile Form		form, if you have not already done so.  The purpose of the form is 
			to collect additional data about which HIPAA transactions you 
			will conduct with MassHealth, and to verify contact information for 
			your facility.
		
continued on back

Media Options	The Division will make the 835 transaction available to MassHealth trading partners for download from the Bulletin Board System (BBS), or on a CD-ROM or DVD.  Trading partners who would like to retrieve 835 transactions from the BBS will be issued a user ID, password, and BBS instructions.

Testing and Support	The Division will provide assistance to trading partners who would like to participate in testing activities; however, testing of the 835 transaction is not required.  If you would like to test, contact the MassHealth HIPAA Support Center at the telephone number or e-mail address below.

Proprietary Remittance	The Division will continue to issue paper remittance advices to all
Advices 	providers.  In addition, the Division will provide the current proprietary 	electronic remittance advice to providers who currently receive it, as 	supplemental information to the 835 transaction.

Acknowledgements		Generation of the 997 Functional Acknowledgement in response to the 
835 transaction is optional for trading partners and is not required by the Division.  However, if a provider chooses to send a 997 acknowledgement, it can be e-mailed to MA997@unisys.com.

Contact	If you want to receive the 835 transaction, please contact us at the
Information	appropriate telephone number below.
			
			Pharmacy Providers:  1-617-423-9841
			All Other Providers:    1-888-848-5068 or at mailto:mahipaasupport@unisys.com

835 Information for	Retail pharmacy providers must contact ACS State Healthcare at 
Pharmacy Providers 	the telephone number above to receive 835 transactions in response to claims submitted via the Pharmacy On-line Processing System (POPS).  You will be notified when secure access to the Web site
http://www.masspharmacy-edi.com is available.  Once notified, an assigned user ID and password will be required to gain access to 835 transactions.

Pharmacy providers will be able to access the 835 Companion Guide later this fall by visiting the Affiliated Computer Services (ACS) Web site at http://www.MassPharmacy.com.