Massachusetts Medicaid: MassHealth

Please follow the Enrollment Instructions below to become an electronic submitter for Massachusetts Medicaid.

 

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed and returned to the MassHealth office prior to initiation of electronic claims submission or inquiry.

1. Trading Partner Agreement

If you have difficulty accessing the link above, please go here to download the form:
http://www.mass.gov/eohhs/gov/laws-regs/privacy-security/masshealth/edi/...

NOTE: You must be an enrolled MassHealth Provider or a billing intermediary acting on behalf of a MassHealth Provider.

If you have any questions regarding any of the documents in this package, please call the MassHealth EDI Technology Support Center at 1-800-841-2900.

 

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

 

Trading Partner Agreement

  • Enter today’s date and your Business/Provider name and your Medicaid Number in the first paragraph.

  • Complete the last page of this form with your name and contact information.

 

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:

 

MassHealth Customer Service
Attn: TPA
P.O. Box 9118
Hingham, MA 02043
 

It is very important that you complete and return the entire enrollment packet as described above.Incomplete packets will not be processed and will be returned to the submitter.

 

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)

After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the MassHealth EDI Technology Support Center at 1-800-841-2900.

 

Testing

Once you have received your Submitter ID and Password from MassHealth, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to MassHealth.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.