Skip to main content

Official State of Rhode Island website

  • Translate this page
  • Change the visual color theme between light or dark modes
  • Adjust the font size from the system default to a larger size
    Original
    Larger
  • Adjust the space between lines of text from the system default to a larger size
    Original
    More
  • Adjust the space between words from the system default to a larger size
    Original
    More
The Executive Office of, Health and Human Services , State of Rhode Island
Home
  • Home
  • Initiatives Toggle child menu
    • Overview
    • American Rescue Plan Act
    • Accountable Entities
    • Behavioral Health System Review
    • Children’s Behavioral Health System of Care
    • Children's Cabinet
    • Children’s Services Provider Relief Program
    • Data Ecosystem
    • Drug Overdose
    • Early Intervention Provider Relief Program
    • Equity Council
    • HCBS Access Program
    • HCBS Final Rule
    • Health Information Technology
    • Healthcare Innovation
    • Healthcare Workforce Transformation
    • I/DD Provider Support Program
    • Integrated Care Initiative
    • LTSS Resiliency Programs
    • LTSS: No Wrong Door
    • Nursing Home Isolation Unit Supplemental Funding
    • Pediatric Primary Care
    • Reinventing Medicaid
    • Workforce Stabilization Loan Program
    • Worker Supports Pause Grants
  • Consumer Toggle child menu
    • Overview
    • Healthcare
    • Info Lines
    • Families With Children
    • Adults
    • Elders
    • Adults With Special Needs
    • Programs & Services
    • Provider Search
    • Health & Dental Plans
    • Websites
    • Fact Sheets & Brochures
    • FPL Guidelines And Eligibility Information
    • 2021 Medicaid Managed Care Member Survey
  • Providers & Partners Toggle child menu
    • Overview
    • Billing And Claims
    • Certification Standards
    • Early Intervention Providers
    • Electronic Visit Verification (EVV)
    • Electronic Health Records (EHR) Incentive Program
    • Fee Schedules
    • Forms & Applications
    • Healthcare Portal
    • HIV AIDS Providers
    • Medicaid Managed Care
    • Provider Enrollment
    • Program Integrity
    • Provider Manuals & Guidelines
    • Provider Training And Education
    • Provider Updates
    • Provider Directories
    • RIte Smiles Reference Materials
  • Reference Center Toggle child menu
    • Overview
    • Forms & Applications
    • Research & Analysis
    • Reports To Government Partners
    • Health Plan Accreditation
    • Civil Monetary Penalties
    • Legislative Updates
    • Rules & Procedures
    • EOHHS Appeals Office
    • Declaratory Orders
    • Medicaid State Plan And 1115 Waiver
    • Medicaid State Plan Scanned PDF Version
    • State Innovation Model (SIM)
  • News Toggle child menu
    • Overview
    • Provider News
    • Press Releases
  • About EOHHS Toggle child menu
    • Overview
    • Secretary of EOHHS
    • Strategic Goals And Priorities
    • Departments
    • Contact
  1. Home
  2. Providers & Partners
  3. Billing And Claims
  4. Electronic Data Interchange (EDI)
  • Providers & Partners
  • Billing And Claims
    • Claims Processing
      • EOB Listing
    • Customer Service
    • Prior Authorization
    • Provider Electronic Solutions (PES) Software
    • Electronic Data Interchange (EDI)
      • RI Medicaid Program HIPAA 5010
      • Trading Partner Enrollment
    • Payment And Processing Schedule
    • Recipient Eligibility Verification
    • Third Party Liability
    • ICD-10 Implementation
  • Certification Standards
  • Early Intervention Providers
    • EI Program Certification Standards
  • Electronic Visit Verification (EVV)
  • Electronic Health Records (EHR) Incentive Program
    • Program Year 2020 Requirements
    • Knowledge Share: Security Risk Assessment Tool
    • Patient Volume Documentation Request
    • Uploading Documents In MAPIR
    • Preparing For EHR Incentive Audits
    • RI DOH Meaningful Use Reporting Capacity
    • Pre-requisites When Registering For The Medicaid EHR Incentive
  • Fee Schedules
  • Forms & Applications
  • Healthcare Portal
  • HIV AIDS Providers
  • Medicaid Managed Care
    • 2022 Medicaid Managed Care Procurement Library
    • Medicaid Managed Care Manual
  • Provider Enrollment
    • Adding A New Provider To An Existing Group
    • RIte Share Providers
    • Local Education Agency (LEA) Providers
    • National Provider Identifier
  • Program Integrity
  • Provider Manuals & Guidelines
    • HIPAA
    • Medicaid Provider Manual
      • Early Intervention Providers
  • Provider Training And Education
  • Provider Updates
  • Provider Directories
    • ICF/IID
    • Provider Representatives
  • RIte Smiles Reference Materials

Electronic Data Interchange (EDI)

All documents are in pdf format

  • RI Medicaid HIPAA 5010
  • Trading Partner Enrollment
  • MMIS Claim Type to HIPAA Crosswalk
  • Claim Status Response - Explanation of Benefits
  • Adjustment Reason Code - Explanation of Benefits
  • Provider Electronic Solutions Software (PES) 

Executive Office of Health and Human Services

3 West Road
Cranston, RI 02920

Connect

Contact Us
Directions

State of Rhode Island

Office of the Governor
RI.gov
Elected Officials
State Agencies (A-Z)

© 2021 RI.gov. This page last updated on March 25th, 2021. Accessibility, data, and privacy policies | Top of page