5010 Transaction Testing Now Available

August 23, 2011

MaineCare providers can now test through the MIHMS HealthPAS online provider portal 5010 Electronic Data Interchange (EDI) transactions.

What resources are available?

The following resources are available online to assist providers with the testing process:

What do providers need to do? - Providers who are going to submit claims to the online portal via electronic batch transactions (EDI X12 files) are required to complete 5010 certification testing. - Providers must submit three test three files with a minimum of fifteen (15) transactions and successfully pass the HIPAA validation for each EDI transaction type (837, 270, 276, and 278,) they plan to submit to MIHMS. - Providers need to successfully complete testing by December 31, 2011 in order to be 5010 certified.

It is important to note that MaineCare will not be able to accept 5010 transactions before January 2012. If a provider attempts to conduct such a transaction before that time, even if they have become 5010 certified, they will receive an error response.

How can providers help?

OMS is soliciting volunteers to participate in pilot provider testing, which is more comprehensive than the 5010 certification testing. Volunteers can be any provider type, including clearinghouses, and billing agents. Volunteers will not only test the system, but will help answer questions from their peers. Pilot testing is tentatively scheduled for early November.

If you would like to volunteer, please contact Matt Galletta at Matt.W.Galletta@maine.gov and put “Volunteer for pilot testing” in the subject line.

Questions about 5010 standards and testing can be directed to the EDI help desk at: mainecaresupport@molinahealthcare.com or by calling 1-866-690-5585 and selecting option 3.