Massachusetts State Seal
|
The Official Website of the Massachusetts Health Care Training Forum
Health Care Training Forum

Member Eligibility - 270/271 Batch Transaction Update

March 11, 2019

On June 23, 2019 MassHealth will implement a change to its member eligibility batch request response logic. The agency will no longer conduct an alternate search of its eligibility database when an invalid Member ID (MID) is submitted in the 270 HIPAA transaction.

Once implemented, when a provider sends in a 270 request with an invalid MID, the provider will receive a 271 response indicating "member not found". Specifically, it will state error code "72" Invalid/Missing Subscriber/Insured ID in the AAA03 - Reject Reason Code segment for Loop 2100B.

MassHealth strongly recommends providers make changes to your eligibility inquiry practices today to ensure that you do not receive unnecessary rejections when the new logic is implemented. Be sure to follow the guidelines posted here: https://www.mass.gov/service-details/eligibility-verification-system-overview.

If you have any questions regarding the member eligibility 270/271 batch transaction update, please contact the MassHealth Customer Service Center at 1-800-841-2900 or edi@mahealth.net. When sending an email, please include your MassHealth Provider ID / Service Location (PID/SL) or your National Provider ID (NPI) number.

If you are not the person within your organization that handles member eligibility, please forward this information to the appropriate staff within your organization or to your vendor.