D. The EDI Partner is prohibited from transferring electronic health care information received from
Partners Behavioral Health Management for any purpose not expressly permitted by or related to
paragraphs II, A,B, and C above.
III. Provisions of the Agreement
A. The EDI Partner agrees to follow the DMA and DMH/DD/SAS billing guidelines as provided to
providers for the submission of Health Care Claim Transactions.
B. All transactions must be formatted in accordance with the HIPAA Implementation Guides available
. Partners Behavioral Health Management will provide
companion guides for the transactions, which specify certain situational data elements. HIPAA
transactions to be exchanged between EDI Partner and Partners Behavioral Health Management are
identified in Appendix A, Transaction Sets.
C. The EDI Partner must complete testing for each of the transactions it will implement and shall not
be allowed to exchange date with Partners Behavioral Health Management in production mode until
testing is satisfactorily passed as determined by Partners Behavioral Health Management.
Successful testing means the ability to successfully pass HIPAA compliance checking and to process
electronic healthcare information transmitted by EDI Partner to Partners Behavioral Health
Management. Partners Behavioral Health Management will accept certification from any third-
party testing and certification entity that has been identified by the Workgroup for Electronic Data
Interchange, Strategic National Implementation Process (WEDi/SNIP) in lieu of an EDI Partner being
tested by Partners Behavioral Health Management.
D. The EDI Partner warrants and represents that is has a legally binding contract between itself and all
providers for whom it is submitting data or that the EDI Partner is itself a provider authorized to
submit claims and receive health care information for beneficiaries who have coverage for services
by Partners Behavioral Health Management. The EDI Partner shall indemnify and hold Partners
Behavioral Health Management harmless from any claim, actions, or costs that result from a breach
or threatened breach of this warranty and representation.
E. Partners Behavioral Health Management and the EDI Partner will protect the health care
information contained in the exchange of information by means of both physical and electronic
1. Each entity will control access to its physical locations so that only authorized personnel
have access to the information.
2. Each entity will utilize passwords in accordance with established procedures so that only
authorized personnel have knowledge of those passwords. Upon departure of personnel