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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
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    • Provider Electronic Solutions (PES) Software
    • Electronic Data Interchange (EDI)
      • RI Medicaid Program HIPAA 5010
      • Trading Partner Enrollment
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  • Certification Standards
  • Dental Services
  • Early Intervention Providers
    • EI Program Certification Standards
  • Electronic Visit Verification (EVV)
  • Fee Schedules
  • Forms & Applications
  • Healthcare Portal
  • HIV AIDS Providers
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    • 2023 Medicaid Managed Care Procurement Library
    • Addendum D – Managed Care Organization Request for Qualification Financial Bidder’s Packet
    • Medicaid Managed Care Manual
    • Non-Emergency Medical Transportation (NEMT) Manual
    • Public Comments
  • Provider Enrollment
    • Adding A New Provider To An Existing Group
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  • Provider Training And Education
  • Provider Updates
  • Provider Directories
    • ICF/IID
    • Provider Representatives
  • COVID-19 Emergency Case Management
  • 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) 
Medicaid Recipients: What You need to know as the COVID-19 Public Health Emergency comes to an end

Executive Office of Health and Human Services

3 West Road
Cranston, RI 02920

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