EDI enrollment and testing required to prepare for new Provider Portal

The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Medicaid Management Information System (MMIS) – which will include a new Provider Portal – known as MESA: Medicaid Enterprise System Assistance. The new system, going live at the beginning of October, is being developed by Gainwell Technologies.

EDI testing is now underway, and trading partners are asked to enroll as soon as possible to be able to test EDI submissions to MESA.

What you need to do:

Pharmacy Medicaid Fee for Service (FFS) Providers:

• If you are submitting only NCPDP POS transactions, you are NOT required to enroll as an EDI Trading Partner. Gainwell is coordinating with switch vendors to ensure adequate testing prior to go-live.
• Effective 10/1/2022 at 6 a.m., BIN: 025151 and PCN: DRMSPROD will be required to submit Medicaid fee for service pharmacy NCPDP POS claims.
• The MESA Medicaid Provider Portal is an online tool which will allow you the ability to submit pharmacy claims, inquire on claims, verify beneficiary eligibility, review your enrollment status, and perform drug coverage inquiries. To use this online tool you must register via the MESA Medicaid Provider Portal when it becomes available in late September. You are NOT required to enroll as a Trading Partner in any environment to submit claims via the portal.

Non-Pharmacy Medicaid FFS Providers:

• If you are a Provider that will be submitting EDI compliant batch transactions (either EDI HIPAA or NCPDP) you are required to enroll as an EDI Trading Partner.
• If you are a Provider that has a Clearinghouse that will be submitting EDI compliant batch transactions on your behalf, you are NOT required to enroll as an EDI Trading Partner (but please ensure that your trading partner is enrolled as an EDI Trading Partner).
• If you are a Provider that will be submitting via the Gainwell Medicaid Provider Portal (via direct data entry) you are required to register as a Provider via the MESA Production Medicaid Provider Portal when it becomes available later in September. You are NOT required to enroll as a Trading Partner in any environment.

Trading Partners/Clearing Houses:

• If you are a Trading Partner/Clearinghouse that will be submitting EDI compliant batch transactions (either EDI HIPAA or NCPDP) you are required to enroll as an EDI Trading Partner.
• If you are a Trading Partner/Clearinghouse that will be submitting EDI compliant batch transactions on behalf of a Provider(s), you will need to coordinate association by sharing your newly assigned Trading Partner ID with your Provider(s) after successful enrollment as an EDI Trading Partner.

To enroll as a Trading Partner in the MESA system and set up your account, follow the steps outlined in the Enrollment and Testing Guidelines, which contain detailed Gainwell instructions online at: https://medicaid.ms.gov/electronic-data-interchange-edi-testing/

If providers have any questions about which representatives should be designated to follow these steps, please contact Gainwell’s Help Desk at MS_EDI_Helpdesk@gainwelltechnologies.com.

– Published Aug 19, 2022