Ohio Department of Mental Health Provider Information

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Provider Information

HIPAA requires all covered entities to comply with administrative simplification standards related to the transactions, code sets and provider identifiers required for electronic exchange of data. Covered entities include all health care providers who conduct certain transactions electronically, health care clearinghouses and health plans.

Transactions
All providers who intend to bill electronically through MACSIS must obtain a national provider identifier and be approved to submit professional service claims using the required HIPAA format. In return, they will receive an electronic health care claim/payment advice through their remitting MH/ADAS board. For more information, select one of the following:

837 Professional Claim File Approval Instructions
Technical Guide - 835 Health Care Claim/Payment Advice Version 4010 – NPI Format
- Sample 835 NPI File
- MACSIS Paper Remittance Advice Information

Code Sets
All code sets used on the HIPAA-mandated file formats are documented on the MACSIS Codes and Related Documents page.

Provider Identifiers
The National Provider Identifier (NPI) is a unique health care provider identifier number used to distinguish individual practitioners or provider organizations during standard electronic health care transactions. Learn more about obtaining an NPI.