Today, over 85% of MassHealth claims are submitted electronically. The HIPAA-compliant 837 electronic 
transaction is the most efficient and accurate method to send your claims to MassHealth. By increasing your 
productivity and cash flow, and minimizing the chance of errors on submitted claims, electronic submission will 
simplify the way you submit your claims to MassHealth. If you aren’t submitting your claims electronically, 
what are you waiting for? 

Benefits of Electronic Billing 

• cleaner claims and fewer errors 


• less clerical handling and decreased labor requirements 


• void and replacement transaction 


• increased cash flow 


• automatic posting of receivables 


• useful management information 




With great benefits like these, electronic submission is the way to go if you want to simplify your billing 
procedures. In case you have any lingering doubts, consider the following before you decide if it makes more 
sense for you to submit your own claims or use a vendor. 

Important Issues to Consider 

• Should I purchase software from a vendor or can my existing vendor meet my needs? 


• Should I contract the services of a billing intermediary or a claims clearinghouse? 


• Will my software allow me to bill other insurance carriers as well as MassHealth? 


• How much will this cost? 


• Is my vendor able to support electronic posting of claims? 




Using a Vendor 

MassHealth has a list of approved vendors that specifies which transactions they support. The MassHealth 
vendor list can be downloaded from the MassHealth Web site under the Information for MassHealth Providers 
link. 

To learn more about electronic claims submission and how to integrate this automated solution into your 
procedures, check out the EDI and HIPAA section of the MassHealth Web site at 
www.mass.gov/masshealth. Click on Information for MassHealth Providers, then on MassHealth and 
HIPAA, and then on EDI and HIPAA Information for Providers. This section has helpful tools like 
companion guides and testing resources. 

For more information, contact HIPAA Support at MassHealth Customer Service by e-mail at 
hipaasupport@mahealth.net or by phone at 1-800-841-2900. Dental providers should consult their Office 
Reference Manual, or send an e-mail to eclaims@masshealth-dental.net, or call 1-800-207-5019.