Issued: June 28, 2024

Partners Health Management has implemented the ability to complete 270/271 processing. The 270 transaction is used to request eligibility and benefit information for medical and behavioral lines of business; the 271 transaction is sued to respond with information for the specified member.

What is happening?

  • Partners has implemented the ability to complete 270/271 processing.
  • The 270 transaction is used to request eligibility and benefit information for medical and behavioral lines of business.
  • The 271 transaction is used to respond with information for the specified member.

What do providers need to do?

Step 1: Contact Partners

Initiate contact with Partners through their designated channels, such as ProviderCONNECT (partnersbhm.org/tailoredplan/providers/providerconnect/), customer support email (sysaid2@partnersbhm.onmicrosoft.com), or via phone at 704-842-6431. Express your interest in submitting 270 and 271 EDI files. Be prepared to provide basic information about your organization, such as your provider, company name, contact information, etc. Partners will assign a System Administrator to guide you through the submission process.

Step 2: Obtain Trading Partner Agreement

Partners will provide you with a Trading Partner Agreement, which serves as a legal contract outlining the terms and conditions of your partnership. This agreement typically covers important aspects such as data security, confidentiality, compliance with industry regulations (such as HIPAA for healthcare data) and the responsibilities of each party involved. Please note: If an agreement is already in place to submit claims and other information to Partners, this form will be an addendum to the original agreement.

Trading Partners Agreement (TPA): available on Partners Provider Knowledge Base website at providers.partnersbhm.org/submitting-270-271/.

Step 3: Complete and Sign Trading Partner Agreement

Thoroughly review the Trading Partner Agreement provided by Partners. Ensure that all sections are completed accurately, including your organization’s legal name, address, contact information, and any specific terms or requirements outlined in the agreement. Once reviewed and approved, sign the agreement using an authorized signature and return it to Partners for processing.

Step 4: Receive Confirmation

Partners will acknowledge receipt of the signed Trading Partner Agreement and may provide you with confirmation of acceptance. This confirmation may include additional instructions or documentation required for the onboarding process, such as access credentials for their EDI platform or contact information from our technical support team technical support team.

Step 5: Implementation Guides

  • Partners uses the standard ASC X12 Health Care Eligibility Benefit Inquiry and Response Consolidated 270/271 Guide and the NCTracks Companion Guide: 270 271 Companion Guide.pdf to guide you with the technical specifications and requirements for formatting and submitting 270 EDI files.
  • Supplemental Guide: The Supplemental Guide is available at partnersbhm.org/submitting-270-271/.
  • Partners uses the standard ASC X12 Health Care Eligibility Benefit Inquiry and Response Consolidated 270/271 Guide and the NCTracks Companion Guide: 276 277 Companion Guide.pdf to guide you with the technical specifications and requirements for formatting and submitting 270 EDI files.

Step 6: Prepare EDI Files

Utilizing your internal systems or EDI software, generate EDI files according to the specifications outlined in the Implementation Guide provided by Partners. Ensure that your files are formatted correctly and contain accurate data to prevent processing errors or rejections by Partners’ systems.

Step 7: Testing Phase

Participate in a testing phase with Partners to validate the compatibility of your EDI files within your EDI system. Partners may provide test environments or designated testing periods for you to submit sample files and receive feedback on their compliance with their requirements. Address any issues or discrepancies identified during testing in collaboration with Partners’ technical support team.

Step 8: Production Submission

Once testing is successfully completed and your files are validated, you can transition to submitting your EDI files in the production environment. Follow the agreed-upon schedule for file submission and ensure compliance with any additional protocols or procedures specified by Partners. Monitor the submission process closely and promptly address any errors or rejections encountered during production submissions.

Step 9: Ongoing Support and Communication

Maintain regular communication with Partners to address any questions, concerns, or technical issues that may arise during the submission process. Proactively notify Partners of any changes to your systems or processes that may impact the submission of any EDI files. Stay informed about updates or changes to Partners’ requirements and adapt your processes accordingly to ensure continued compliance and smooth operation of the partnership.

If you require further assistance or clarification on any aspect of the process, do not hesitate to reach out to Partners’ support team for guidance.

Who can providers contact with questions?