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Check claim status

Learn how to check the status of your MassHealth claim on the Provider Online Service Center (POSC).

MassHealth Customer Service Center for Providers

The Details of Check claim status

What you need for Check claim status

  • Your POSC login information, if you are checking online
  • Your MassHealth Provider ID/Service Location Identifier
  • Either of the following:
    • Claim internal control number (ICN)
    • Member's MassHealth ID and date(s) of service(s)

You can only submit non-dental and non-pharmacy claims through the POSC

How to check Check claim status

Providers can check claims that were submitted to MassHealth by logging onto the POSC and searching individually, by batch, or by reviewing the MassHealth Remittance Advice (RA).

The 276/277 HIPAA-compliant electronic transaction is the standard for claim status inquiries to determine if a claim is paid, denied or suspended. Through the 276/277 transaction, claim status can be verified 24/7 using the POSC.

Through the POSC

For checking individual claim status

  1. Login to the POSC.
  2. Open Manage Claims and Payments.
  3. Click Inquire Claims Status to open the Search for Claims panel.
  4. Select Provider ID from the drop-down list.
  5. Enter either:
    • The ICN.
    • The Member ID and the From Date of Service and To Date of Service.
  6. Click Search.
  7. Users can press the "print" button on their browser to print a copy of the claim status.

For checking batch claim status

  1. Login to the POSC.
  2. Upload a 276 batch file to request to check claim status.
  3. Within 2 to 24 hours after submitting a 276 request, MassHealth will generate a 999 acknowledgement file if the 276 passes pre-compliance.
    • The 999 will contain data indicating the number of transaction sets received in the 276 file and their status.
    • The AK9 segment will give the overall compliance of the file.
    • The IK501 data element will give a status of the transaction set.
  4. Providers can download and review the 999 from the Provider Online Service Center (POSC) for each 276 file submitted.
    • A status of “A” in the AK901 indicates that the file was accepted.
    • A status of “R” in the AK901 indicates that the file was rejected.
    • A status of “P” in the AK901 indicates that the file was partially accepted.
    • A status of “R” in the IK501 indicates that the transaction set was rejected.
  5. Download the 277 response for the status of the claims submitted in the 276 file.

For checking via the RA

The RA is available on the POSC in two forms:

  • The 835 electronic RA file
  • The PDF RA

Next steps for Check claim status

Rejection or partial acceptance of batch claim status requests

If the file was rejected or partially accepted, providers must correct the errors and resubmit the file.

Contact the MassHealth Electronic Data Interchange (EDI) team for assistance at:

Downloads for Check claim status

Contact for Check claim status

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