Before January 1, 2027: Billing team and providers must implement comprehensive data validation procedures for all MassHealth claims submitted to Point32Health. SPECIFIC ACTIONS: (1) Audit all claim submission workflows to ensure valid, up-to-date provider taxonomy codes (from NUCC Health Care Provider Taxonomy Code Set) are included for billing, attending, and rendering providers on ALL medical encounter submissions except pharmacy claims; (2) Verify all claims contain valid 10-digit NPIs in appropriate data elements for billing, attending, referring, rendering, and operating providers, with exceptions only for atypical providers not issued NPIs; (3) For inpatient hospital claims (with applicable exceptions for certain bill types), require valid admission date AND admission hour, and valid discharge date AND discharge hour; (4) Implement validation rules to ensure only valid, active diagnosis codes appropriate for the date of service are submitted as primary diagnoses; (5) Verify all occurrence codes accurately reflect member treatment and clinical history; (6) Cross-reference all revenue codes against current MassHealth guidance and fee schedules to ensure only valid, reimbursable codes are submitted; (7) For physician-administered drug claims, mandate valid 11-digit NDC, appropriate unit of measure (F2, GE, ME, ML, or UN), and quantity greater than 0.0; (8) Ensure all procedure codes, modifiers, diagnosis codes, and other standardized codes comply with current code set requirements. WHO: Billing team (system configuration and validation setup), Providers (accurate data submission), and Compliance/Revenue Cycle leadership (oversight and monitoring). WHERE: Update billing system validation rules, claim submission templates, and encounter forms; configure system edits and hard stops to prevent submission of non-compliant data. CONSEQUENCES: Claims without appropriate taxonomy codes, missing NPIs, invalid admission/discharge information, inactive diagnosis codes, or non-compliant data will be rejected by Point32Health, resulting in claim denials, delayed encounter submission to MassHealth, and delayed or denied reimbursement.