Medicaid is preparing to implement the Real Time 270/271 Eligibility Verification Request and Response and Real Time 276/277 Claim Status Request and Response Transactions. For Real Time transactions, the sender remains connected while the receiver processes the transactions and returns a response to the sender and with an average response time within 20 seconds. Gainwell will utilize a Real Time Safe Harbor interface referred to as HDE (Health Direct EDI). This will allow for trading partners to transmit the Real Time transactions directly to the translator (EDIaaS). 

 HDE connectivity and requirements per CAQH Core Rules 

• Trading Partner Software web service to process transaction 
• Trading Partner transaction can be in SoapUI or MIME format for submission
• Trading Partner will receive a URL, HDE username and password to access the HDE connection. 

What does this mean? If you are a provider, contact your software vendor, clearing house or billing agency. Medicaid does not offer software for these Real Time transactions.  

To participate  

• Do you have a trading partner number?  
• Is your contact information on the Healthcare Portal current? 
• If you have answered yes to the above questions and are interested in these Real Time transactions, please answer the questions below. 

Testing will begin late July to mid-August. 

To participate in testing, you must provide the information below. 

Name, TPID, contact name, email, and telephone number. Identify format (SOAPUI or MIME) for submitting Real Time transactions.  

Send your answers to riediservices@gainwelltechnologies.com. Please make sure to add a subject line of Real Time Transactions.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The June 2023 provider update can be found here. Previous issues can be found on the EOHHS [Executive Office of Health & Human Services] website at the provided link above. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Please see the February 2023 provider update here. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

See the January 2023 Medicaid Provider Update here.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Please see the December 2022 provider update found here on the Executive Officer of Health and Human Services (EOHHS) website.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Please see Medicaid Program November 2022 provider update.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Please find the October 2022 provider update here.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Health has announced their endemic strategy for COVID-19 vaccination and testing.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Health issued a Public Health Alert due to increased opioid overdose activity in Hopkinton, Richmond, East Greenwich, West Greenwich, and Exeter (Region 9). Read the full Alert here.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.