Masshealth Newmmis Implementation Instructions

MassHealth newMMIS Implementation Instructions

Document Revision History

Version / Date / Author / Description
1.0 / November 2008 / Matt Abrahams / Initial Draft
1.1 / November 2008 / Whitt Batcheler / Clean-up of Control File Setup Instructions

Table of Contents

Overview

Installation Instructions

MassHealth newMMIS Implementation Checklist

Control File Changes for Real-time Transactions

HTS Service Setup

Configuring eGateway for Processing of MassHealth newMMIS Transactions

Configuring GSRestore for Processing of MassHealth newMMIS Transactions

Configuring GSRestore Control Files for Other HTS Payers

Control File Changes for Claims-related Transactions

eClaims Partners File

eClaims Mapping File

eClaims Jobs File

HTS Configuration

Account_Logins Setup

Registry Settings

MaMedicaid270Map Program

MaMedicaid276Map Program

GSSenderSave Program

GSSenderRestore Program

SQL Database

MapDetails

TradingPartnerIDMapping

Starting the Service

Wrap-up

Overview

This document contains information on NEHEN’s compatibility with MassHealth’s newMMIS implementation and instructions on how to configure the test and production NEHEN servers for newMMIS implementation.

At the time of the NEHEN 11.8 release, NEHEN Support only had knowledge of testing the newMMIS implementation. Therefore, this document was originally written with testing in mind. Once NEHEN learns more about MassHealth’s production roll-out plans, including the obtaining of production user IDs and provider IDs, this document will be updated with helpful information for production implementation and redistributed to the NEHEN Community.

Some newMMIS requirements have forced significant changes to the processing of MassHealth transactions. The Medicaid service is not used for newMMIS transaction processing. Instead, the HTS service is used. Due to MassHealth’s requirement that the provider’s newMMIS provider ID appear in the GS02 (application node) element of eligibility and claim status inquiry request transactions, NEHEN had to implement a way of putting the original application node value back into the response transaction, so the request and response linked to one another in the application. To do so, new GSSenderSave and GSSenderRestore map programs are used to store and retrieve this information from a new database table. In addition, a new eGateway service, called GSRestore, is needed to do some mapping of transactions before eGateway can process the responses. GSRestore is not used for request transactions. For more information on these new programs, see the NEHEN 11.8 Release Notes.

When sites are ready to test against MassHealth’s newMMIS system, they must obtain a user ID, password, and newMMIS provider IDs to be used in testing. This information is needed for the instructions in this document.

Installation Instructions

Following the instructions in this document will configure the NEHEN server for newMMIS implementation. These instructions should be completed on both test and production servers.

MassHealth newMMISImplementationChecklist

Task / Description
Mapping and Partners file changes for real-time transactions / This task will verify the eGateway is configured to process these transactions.
Mapping, Partners, and Jobs file changes for claims-related transactions / This task will verify the service used (eClaims) is configured to process these transactions.
HTS Configuration / This task will verify the HTS service is configured for connectivity with MassHealth’s newMMIS system.
Account_Logins setup / This task will verify the database table is configured with your site’s NPI, node, and newMMIS provider ID values.
Setup Registry Settings / This task will configure the registry based on your site’s information.
Setup Database Tables / This task will ensure two database tables are configured properly.

Control File Changes for Real-time Transactions

Following the instructions in this section configures the NEHEN server for processing of real-time (eligibility and claim status inquiry) transactions.
GSRestore Service Setup

The port that the GSRestore service listens on is defaulted to 10042, which was chosen since it is unlikely that any other NEHEN service listens on that port. It is necessary to verify no other service is listening on that port on the server. If one is, 10042 cannot be used for this service.

Please use the instructions next to the following bullet points below to locate the InboundPort registry entry for each service using the NEHEN Configurator. Note each inbound port in use to determine whether 10042can be used for this service.

To access a secondary service’s registry values using the Configurator, with the Configurator open, go to NEHEN -> Services -> [name of service], with [name of service] being the name of the service you are checking.
To access the HTS service’s or an instance of the eGateway service’s registry values using the Configurator, with the Configurator open, go to NEHEN -> Services -> [name of service] -> Edit Registry, with [name of service] being the name of the service you are checking.

If port 10042 cannot be used for GSRestore, select a different port number. It can be any number between 9,000 and 11,000 that is not in use by another service as the inbound port. Change the service’s InboundPort registry entry to the port number chosen. Use the instructions next to the first bullet point above to access the service’s registry.

Adding GSRestore as an Available Service in the Configurator

Open the NEHEN Configurator if it is not open.
Go to NEHEN->Services->Available Services to display the “Available Services” window.
Click on the Add button.
Enter the following information into the fields:

Service Name: / GSRestore
Service Description: / GSRestore – NEHEN EDI Service
Service Executable Name: / GSRestore.exe
TCP Port: / 10042 (or, if 10042 is in use by another service, the port number chosen)
Type: / Complex

Click on the OK button to close the form.

Configuring Important Registry Entries ofGSRestore Service

Open the NEHEN Configurator if it is not open.
Go to NEHEN->Services-> GSRestore -> Edit Registry to edit the service’s registry.
Ensure the ISAAddressing registry entry is set to 1.
Ensure the InboundPort registry entry is set to be the port number chosen.

HTS Service Setup

Only complete these instructions if the HTS service was not installed on your site’s server prior to the NEHEN 11.8 Release. If not sure, completing them will not negatively impact the configuration. All sites, regardless of when HTS was installed, should complete the “Configuring Important Registry Entries of HTS Service” section below.
The port that the HTS service listens on is defaulted to 10022, which was chosen since it is unlikely any other NEHEN service listens on that port. It is necessary to verify no other service is listening on that port on the server. If one is, 10022 cannot be used for this service.

Please use the instructions next to the following bullet points to locate the InboundPort registry entry for each service using the NEHEN Configurator. Note each inbound port in use to determine whether 10022 can be used for this service.

To access a secondary service’s registry values using the Configurator, with the Configurator open, go to NEHEN -> Services -> [name of service], with [name of service] being the name of the service you are checking.
To access the HTS service’s or an instance of the eGateway service’s registry values using the Configurator, with the Configurator open, go to NEHEN -> Services -> [name of service] -> Edit Registry, with [name of service] being the name of the service you are checking.

If port 10022 cannot be used for HTS, select a different port number. It can be any number between 9,000 and 11,000 that is not in use by another service as the inbound port. Change the service’s InboundPort registry entry to the port number chosen. Use the instructions next to the first bullet point above to access the service’s registry.

Adding HTS as an Available Service in the Configurator

Open the NEHEN Configurator if it is not open.
Go to NEHEN->Services->Available Services to display the “Available Services” window.
Click on the Add button.
Enter the following information into the fields:

Service Name: / HTS
Service Description: / HTS – NEHEN EDI Service
Service Executable Name: / HTS.exe
TCP Port: / 10022 (or, if 10022 is in use by another service, the port number chosen)
Type: / Simple

Click on the OK button to close the form.

Configuring Important Registry Entries ofHTS Service

Open the NEHEN Configurator if it is not open.
Go to NEHEN->Services->HTS -> Edit Registry to edit the service’s registry.
Ensure the InboundPort registry entry is set to be the port number chosen.
Ensure the RelayPort registry entry is set to the inbound port number of the GSRestore service. This should have been determined in the “GSRestore Service Setup” section above.

Configuring eGateway for Processing of MassHealth newMMIS Transactions

Sites must configure their eGateway services to process MassHealth newMMIS transactions.

Before starting any setup, determine whether your site uses ISAAddressing or GSAddressing for the eGateway service. This information will be used in the eGateway configuration, so please note it.

To determine if eGateway is using ISA addressing, try to find an ISAAddressing registry entry for eGateway (using the instructions to access the service’s registry above). If one is not found or, if one is and it is set to 1, ISA addressing is in use. Otherwise, GS addressing is in use.

Also, before starting any configuration, note each newMMIS provider ID to be used for transaction processing for your site. Each provider ID is a nine-digit number with a one-character service location on the end.

Partners File

Sites must ensure the correct trading partners are configured for processing via the HTS service.

Using NEHEN Configurator

Using the Configurator, go to NEHEN > Services > eGateway > Partners.
See if HTS exists as the Partner ID of one of the trading partners. It is displayed as the value in parentheses in the list of Partners.
If it is not there, add it by clicking the New button, modifying the following values, and clicking the OK button:

Partner Name: / HTS Service
Partner ID: / HTS
Partner Type: / Internal
IP Address: / 127.0.0.1
Port: / the value in the InboundPort registry entry for the HTS service (covered above)
Queue Clear Speed: / 0 (zero)

Click No if asked to restart the service.
See if DMA7384 exists as the Partner ID of one of the trading partners. It is displayed as the value in parentheses in the list of Partners.
If it is not there, add it by clicking the New button, modifying the following values, and clicking the OK button:

Partner Name: / MassHealth newMMIS ID
Partner ID: / DMA7384
Partner Type: / Internal
IP Address: / 127.0.0.1
Port: / 0 (zero)
Queue Clear Speed: / 0 (zero)

Click No if asked to restart the service.
Ensure that each newMMIS provider ID exists as the Partner ID of one of the trading partners. It is displayed as the value in parentheses in the list of Partners.
If one is not there, add it by clicking the New button, modifying the following values, and clicking the OK button:

Partner Name: / newMMIS provider ID <unique info>, where <unique info> is some value that is unique to this provider ID
Partner ID: / newMMIS Provider ID
Partner Type: / Internal
IP Address: / 127.0.0.1
Port: / 0 (zero)
Queue Clear Speed: / 0 (zero)

Repeat steps 8 and 9 for each newMMIS provider ID to be used in real-time transactions.
When done with the Partners file, click OK to close the window.

Using the Partners.txt File

Use these instructions if your site has not converted to the XML files.

Open the Partners.txt file in the “\Program Files\NEHEN\eGateway\Control” folder.
See if HTS exists as the Partner ID of one of the trading partners. It is the second parameter on a trading partner line.
If it is not there, add the following line with no spaces after the first comma and with x being the value in the InboundPort registry entry for the HTS service (covered above):
HTS Service,HTS,127.0.0.1,x
See if DMA7384 exists as the Partner ID of one of the trading partners. It is the second parameter on a trading partner line.
If it is not there, add the following line with no spaces after the first comma:
MassHealth newMMIS ID,DMA7384,127.0.0.1,0
Ensure each newMMIS provider ID exists as the Partner ID of one of the trading partners. It is the second parameter on a trading partner line.
If one is not there,add the following line with no spaces after the first comma, filling in the bracketed values with pertinent information:
newMMIS provider ID <unique info>,<newMMIS provider ID>,127.0.0.1,0
Repeat steps 6 and 7 for each newMMIS provider ID to be used in real-time transactions.
Save and close the file.

Mapping File

For processing of transactions sent via HTS, it is necessary to configure new mapping transformations for 270 transactions and for 271 transactions for each application your site uses to submit MassHealth eligibility transactions. The same applies to 276 and 277 transactions. Also, it is necessary to modify any existing Mapping entries to invoke new map programs and send the transactions to the HTS service. Because of the changes to the file, we recommend creating a backup copy of the Mapping.xml or Mapping.txt file in the “\Program Files\NEHEN\eGateway\Control” folder prior to making any changes.
Please compile a list of application sender IDs (or node values) your site uses, using the following information:

If your site’s eGateway service uses ISA addressing, the only sender ID should be your site’s NEHEN ID.
If your site’s eGateway service uses GS addressing, application sender IDs (or node values) are the values found in the GS02 element of 270s or 276s and the GS03 element of 271s or 277s. Examples are 00000001R, 00000003B, and 00000003R. Identify all application nodes used by your site. A good way to do this is to use the eGateway Mapping file by doing either of the following:
If using XML files, using the Configurator, go to NEHEN -> Services -> eGateway -> Mapping and look at the Sender value of the 270 entries. It is necessary to click on each transformation to see the actual application sender ID in the Sender drop-down box in the Transformation Information section. The ID is in parentheses.
If using text files, open the “Mapping.txt” file found in the “\Program Files\NEHEN\eGateway\Control” folder, locate all lines beginning with “270”, and note the third parameter of those lines (with “270” being the first).

Before adding a transformation, ensure one with the same first five parameters does not already exist. Using the Configurator, the Mapping file is found by going to NEHEN -> Services -> eGateway -> Mapping and, after clicking on a transformation, the first five parameters are listed in the Transformation Information section with the trading partner IDs in parentheses. For sites not using the XML files, in the Mapping.txt file in the “\Program Files\NEHEN\eGateway\Control” folder, the first five parameters are listed at the start of each transformation. Compare them to the first five below in the given order. If the mapping transformations already exist, please ensure they are configured with the information listed below. Also, if they do not already exist, but ones with the same Transaction Type, Sender, and Receiver do, modify those transformations to be like the transformations below.

MassHealth newMMIS 270 Mapping Transformation #1

One MassHealth 270 mapping transformation should look like the following. Note that, if two values are listed below, it is because the setup choices in the text file and the Configurator differ. Please set up one transformation for each sender ID. The action list should appear in the order shown.

Transaction Type: / 270
Implementation Guide: / ? or “Any Implementation Guide”
Sender: / One of your site’s Sender IDs (e.g., 00000001R,00000003B)
Receiver: / NEHEN005
File Type: / ? or Either
Action List
Map Action
Executable Name: / \Program Files\NEHEN\eGateway\Maps\GSSenderSave.exe
Map Name: / NotALot
Map Action
Executable Name: / \Program Files\NEHEN\eGateway\Maps\MaMedicaid270Map.exe
Map Name: / NotALot
Transport
Method: / Direct
Send To: / HTS Service (if using the Configurator) or HTS (if using Mapping.txt)
Protocol: / NEHEN
Connect at Startup: / No
Keep Connection Alive: / No

MassHealth newMMIS 270 Mapping Transformation #2
In addition to the first 270 mapping transformation, another one needs to be created because of the IDs found in the transactions after they are run through the two map programs. This mapping transformation should be created for each newMMIS provider ID to be used for real-time transaction processing.
The MassHealth newMMIS post-mapped 270 mapping transformation should look like the following. Note that, if two values are listed below, it is because the setup choices in the text file and the Configurator differ.

Transaction Type: / 270
Implementation Guide: / ? or “Any Implementation Guide”
Sender: / newMMIS Provider ID
Receiver: / DMA7384
File Type: / ? or Either
Action List
Transport
Method: / Direct
Send To: / HTS Service (if using the Configurator) or HTS (if using Mapping.txt)
Protocol: / NEHEN
Connect at Startup: / No
Keep Connection Alive: / No

It is not necessary to configure 271 Mapping transformations in the eGateway service since the existing ones will suffice.

MassHealth newMMIS 276 Mapping Transformation #1

One MassHealth newMMIS 276 mapping transformation should look like the following. Note that, if two values are listed below, it is because the setup choices in the text file and the Configurator differ. Please set up one transformation for each sender ID that submits claim status inquiry transactions. The action list should appear in the order shown.

Transaction Type: / 276
Implementation Guide: / ? or “Any Implementation Guide”
Sender: / NEHEN005
Receiver: / One of your site’s Sender IDs (e.g., 00000001R,00000003B)
File Type: / ? or Either
Action List
Map Action
Executable Name: / \Program Files\NEHEN\eGateway\Maps\GSSenderSave.exe
Map Name: / NotALot
Map Action
Executable Name: / \Program Files\NEHEN\eGateway\Maps\GenMap.exe
Map Name: / NewMMIS276Map
Transport
Method: / Direct
Send To: / HTS Service (if using the Configurator) or HTS (if using Mapping.txt)
Protocol: / NEHEN
Connect at Startup: / No
Keep Connection Alive: / No

MassHealth newMMIS 276 Mapping Transformation #2