Washington State Medicaid 270/271 HIPAA Transaction Notes

Washington State Medicaid 270/271 HIPAAWashington State Medicaid 270/271 HIPAA Transaction guidelines adopted under HIPAA clarify and specifiy the data content when exchanging electronically with Washington State Medicaid. When the trading partner submits the 270 request by any one of the specified methods the 270 request will be validated using EDI validator (up to levels HIPAA validation level 1 & 2), translated and will be processed. The positive outcome will be the 271 response. Negative outcomes will result in negative TA1 and/or 999 transactions.

To determine if the file was successfully validated and processed through tyhe vendor portal partner should go to the ProviderOne main page, select Retrieve HIPAA Batch Response, and follow these steps:

  • Select 270 from the Transaction Type drop down menu
  • There are 3 filter boxes available that contain the following filter criteria that you can use to search for the submitted HIPAA file
    • File Name
    • ProviderOne ID
    • Response Date
    • Upload/Sent Date

An example of a search would be %Your ProviderOne ID%. The % are considered wildcard searches.  Example: %123456700% .

Click on Go once you’ve entered all the necessary filters. Keep in mind you can enter up to 3 filters to refine the search of your submitted HIPAA 270 transaction. All the HIPAA transactions that match your search criteria will return on the page. Click on the down arrow in the Upload/Sent Date column to sort for the most current files to least current files. Now look for Accepted or Rejected in the Acknowledgement Status Column.

Accepted means the 270 file will be processed and the 271 will be generated o Rejected means the file will not be processed due to errors. Partial means some of the file was processed but not all of it due to errors.

If the test file generates a negative TA1 or negative 999 acknowledgments, then the submission is unsuccessful and the file is rejected. The trading partner needs to resolve all the errors that are reported on the negative TA1 or negative 999 and resubmit the file for test. Trading partners will continue to test in the testing environment until they receive a positive TA1 and positive 999. Receipt of a positive TA1 and 999 transaction is considered successful testing. Trading partners are allowed to submit production files once they successfully completed testing.

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