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Medical Associates Health Plans and Health Choices 270/271 HIPAA Transaction Requirements

270/271 HIPAA transmissions are used in tandem with the v5010 ASC X12N Implementation Guides, are compliant with both ASC X12 syntax and those guides. MAHP/HC currently uses Change HealthCare as the exclusive clearinghouse for managing 270/271 connections. Learn the instructions needed to get connected and start sending/receiving standard 270 and 271 transactions with Change HealthCare.

270/271 Transaction Process Flow

The process flow for the 270/271 transaction exchange will involve two separate entities: The provider or clearinghouse sending the benefit request, and Change HealthCare. Change HealthCare will serve as an intermediary between the request source and MAHP/HC, storing the benefit data for MAHP/HC and exchanging the benefit response through their secure connections.

Change HealthCare will return a 271 response or 999 (in case of failed validation) within 20 seconds of receiving the 270 request from a submitter to provide as close to a real-time response as possible. Automation is currently configured to run 24 hours a day in order to process requests as submitted.

Communication Protocols

Change HealthCare’s security protocol is Username/Password. Change HealthCare does not use X.509. The currently supported protocol for CORE is HTTP/S. The following is a list of standards and the versions that this Rule is based on:

  • HTTP Version 1.1
  • SSL Version 3.0
  • MIME Version 1.0
  • The MIME Multipart/Form-Data (IETF RFC 2388)
  • SOAP Version 1.2
  • WSDL Version 1.1
  • Web Services-Security 1.1 Change HealthCare utilizes SOAP, MIME/Multipart, and WSDL.

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