Official State of Rhode Island website

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The Executive Office of, Health and Human Services , State of Rhode Island

RI Medicaid Program HIPAA 5010

RI Medicaid HIPAA Companion Guide

The RI Medicaid Companion Guide includes the technical specifications for the:

  • 837 version 5010 for institutional, professional and dental electronic claims
  • 999 functional acknowledgement
  • 277 unsolicited claim response
  • 835 electronic remittance
  • 270/271 Eligibility Request/Response

These specifications are to be used in conjunction with the National Electronic Data Interchange Transaction Set Implementation Guides to provide supplemental information specific to RI Medicaid as permitted within the structures of the HIPAA transaction sets.

Information pertaining to the Gainwell Technologies translator, interface specifications, the Trading Partner Agreement, Provider Services contacts, and HIPAA resources are also contained in this document.

Other Resources

For additional information visit RI Health Insurance Portability & Accountability Act (HIPAA)