• This page, Trading Partner Education, is   offered by
  • MassHealth

Trading Partner Education

This page outlines Electronic Data Interchange (EDI) initiatives that impact HIPAA transactions and related Provider Online Service Center (POSC) Direct Data Entry (DDE) submissions for all affected Trading Partners. The information within this page may include minor updates to content, system modifications, new initiatives, and provide relevant resources. Please view the EDI initiatives below.

Table of Contents

837 Modifications

On March 14, 2021, MassHealth will implement minor modifications to the submission requirements related to operating physician, service facility location, and supervising physician information submitted on 837 claims transactions (Batch & DDE).

Information Sessions - Trading Partner Testing (TPT) Office Hours

MassHealth will conduct general information sessions for providers, trading partners, and vendors beginning in late January. The dates, meeting registration link, and meeting documents for each session are listed below:

  • ​​Session 1 - Wednesday Jan 27 10-11 AM PDF | Word
  • Session 2 - Wednesday Feb 17 2-3 PM PDF | Word

 

837 Modification Resources

DDE Claims Updates Information Sheet  PDF | Word

POSC Job Aid DDE Institutional Claims Submission Updates PDF | Word

POSC Job Aid DDE Professional Claims Submission Updates PDF | Word

270/271 Modifications

On July 1, 2021, MassHealth will implement a minor change to the HIPAA Health Care Benefit Inquiry and Response (270/271) transaction. This will impact both Real-Time and Batch transactions. The change is limited to the electronic eligibility response (271) file only. The 271 response will remove a segment and will include modified information in Loop 2110C – Subscriber Eligibility or Benefit Information (EB01, 02 03, 06, 07, MSG) .

Information Sessions

Information sessions/office hours information will be posted on this page when available.

270/271 - TPT testing 

Trading Partners and vendors who are interested in testing this modification will have an opportunity to test the receipt of the additional information beginning in early April 2021.

If you would like learn more about the changes and/or need to participate in TPT to test your system changes, please contact MassHealth EDI at edi@mahealth.net or (800) 841-2900

270/271 Modification Resources 

The updated MassHealth 270/271 Companion Guide is available for download on the MassHealth website here: https://www.mass.gov/lists/masshealth-hipaa-companion-guides

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