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Update - Social Security Number Change Update

October 7, 2019

On December 16, 2019 MassHealth will no longer return the member social security number (SSN) in the Health Care Benefit Response (271) unless the correct SSN is submitted on the Health Care Benefit Inquiry (270) request.

MassHealth recommends using a valid Member ID (MID) or member demographic data (e.g. first name, last name, DOB, gender) instead of an SSN when checking eligibility. Please take note of this change and adjust your systems and processes accordingly.

On January 1, 2020 MassHealth will no longer accept the Health Insurance Claim Number (HICN) on the Health Care Benefit Inquiry (270), the Health Care Claim: Institutional and Professional (837), as well as the corresponding Direct Data Entry (DDE) via the Provider Online Service Center (POSC) on Medicare crossover claims. The Medicare Beneficiary Identifier (MBI) will replace the existing 11 digit HICN. Providers need to supply the new 11 digit MBI on all relevant transactions.

MassHealth will send the MBI only on the following outbound transactions:

  • Health Care Benefit Response (271)
  • Health Care Benefit Enrollment and Maintenance (834) 

MassHealth recommends that trading partners prepare for this transition by validating that any involved systems can support the submission and receipt of the alpha-numeric MBI in relevant transactions.

If you have any questions, please contact the MassHealth EDI team at 1-800-841-2900 or EDI@MAHealth.net.