A trade agreement (TPA) is “an agreement between covered companies (HIPAA settlements: 45 CFR Part 162.915) that conduct EDI transactions. The TPP defines the rules and responsibilities of each party involved in the transaction and provides an indication, in addition to requirements such as communication and financing agreements (e.g. B, the entity responsible for telecommunications costs). Please contact us at (800) 841-2900 for a copy of the guide or email to EDI@mahealth.net Here are the reference tools available to successfully manage your 835 transactional processing. Depending on how your organization manages 835 processing, you may need a copy of the following documents specific to your type of transaction: For a copy of the MassHealth Companion guides, contact us at (800) 841-2900 or email your request to EDI@mahealth.net. All participating masshealth suppliers are required to complete and submit a TPA, even if they do not intend to submit claims electronically. You can download the masshealth Trading Partner agreement via the link below. An implementation manual is provided for each transaction. It is accompanied by a MassHealth Companion guide and appropriate billing instructions to manage suppliers when submitting transactions to MassHealth. If you did not receive 999 within 24 hours of filing your 270/271, 276/277 or 837 file, you can contact us at (800) 841-2900 to learn more about status. Managing your 835 transaction processing is specific to your organization.
Your computer scientists can process file 835 and use it for booking, or you are responsible for interpreting the results of claims. You should have a copy of the accompanying manuals specific to your type of transaction (i.e. 270/271, 276/277, 820, 834 Entries, 834 from, 837I and 837P). The 999 is a transaction defined by HIPAA that shows the acknowledgment and status of each function group in an EDI X12 file containing transactions. A companion manual is used in conjunction with the ASC X12 HIPAA implementation guide. It explains how a particular payer interprets the data elements and information they need to process claims. Contact us at (800) 841-2900 or EDI@mahealth.net by email to coordinate the parameters needed to receive transaction 835. Depending on whether you are a supplier who is a clearing house or a settlement agent, a supplier that files your own claims or an organization that manages multiple suppliers, there is clear information that is needed to complete the registration process.
MassHealth has created a useful billing brochure (see link below) to explain how to read your 999. For more information, see the 999 Transaction Implementation Guide, hipaa rules and online implementation guides at www.wpc-edi.com.