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The Executive Office of, Health and Human Services , State of Rhode Island
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  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
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    • 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
    • 2023 Medicaid Managed Care Procurement Library
    • Addendum D – Managed Care Organization Request for Qualification Financial Bidder’s Packet
    • Medicaid Managed Care Manual
  • Provider Enrollment
    • Adding A New Provider To An Existing Group
    • Medicaid Managed Care Organization Enrollment
    • RIte Share Providers
    • Local Education Agency (LEA) Providers
    • National Provider Identifier
  • Program Integrity
  • Provider Manuals & Guidelines
    • HIPAA
    • Medicaid Provider Manual
      • Early Intervention Providers
      • Pharmacy
  • 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

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