For dates of service April 1, 2023, forward
Commonwealth Care Alliance Massachusetts and CCA Health Rhode Island have partnered with Cognizant to implement our new claims platform, Facets, effective April 1, 2023. The new claims platform includes access to the Availity® Essentials Provider Portal. Making this shift allows CCA to use one claims platform and improve our timeliness and predictability of claims payment. Facets also allows providers to use one system for confirming member eligibility for all Massachusetts and Rhode Island product lines.
There are several ways to quickly confirm a member’s eligibility for all CCA Massachusetts and Rhode Island product lines:
- Use the Availity Essentials Provider Portal*
- Use the CCA Provider Portal
- Use the NEHEN Provider Portal*
- Contact CCA Provider Services at 866-420-9332
Electronic Data Interchange (EDI) transactions:
The new claims platform allows trading partners and vendors to submit 837 claim submissions, submit real-time eligibility and benefit inquiries (270/271), and claim status transactions (276/277). For more information, please refer to the EDI Companion Guide.
Provider Manual
Updated provider manuals include eligibility, claims, key contacts and more.
Massachusetts:
Rhode Island:
*Supports batch eligibility transactions