HSN Claims Information for Hospitals

SENDS-INET Instructions
Frequently Asked Questions

MMIS Claims Migration 

Special Circumstances Web Application User Guide (PDF)  | Word  file size 4MB

837P Billing Guide (PDF)  | Word      

837I Billing Guide (PDF)  | Word      

Coding of modifiers

As previously communicated and noted in the HSN Billing Guides, providers should submit HSN claims in accordance with MMIS billing requirements unless specifically noted otherwise in the HSN Billing Guides. Below are links to MassHealth regulations and All Provider Bulletins that providers can refer to.

• MassHealth All Provider Bulletin 227 
• MassHealth All Provider Bulletin 209 
• MassHealth Provider Library Bulletins
• Surgery and Anesthesia rate regulation  file size 1MB
• Clinical Laboratory rate regulation 

Questions regarding these billing requirements should be directed to the MassHealth CST at (800) 841-2900 or ProviderSupport@mahealth.net

Duplicate Claims

Under no circumstances should duplicate claims ever be submitted. Resubmission of previously paid claims should always be submitted as an adjustment, never as an original claim and occur only when a change to submitted claims data is warranted. Providers with questions regarding this communication should contact the MassHealth CST at (800) 841-2900 or ProviderSupport@mahealth.net.

HSN Hospital Payment Schedule

With claims migration and the submission of Reimbursable Health Services (RHS) via three claim sources (837I, 837P, 837D), an adjustment to the existing HSN refresh / payment cycle is needed. Please note that, beginning with the initial HSN claim-based payment period and going forward, the HSN refresh and payment cycles will be based on the following:

• HSN payment period will continue to be based on calendar month that HSN claims were submitted and processed (i.e., November)
• HSN refresh period will begin and the beginning of a month and be based on claims submitted during the previous payment period (i.e., December refresh would be based on November payment period)
• HSN remittances will be posted on INET by the 10^th of a payment month (using the timeline above, remits would be posted on INET by January 10)
• HSN payments will be released by the end of a payment month (using the timeline above, payment would be released by January 31.)

Providers should contact the HSN Help Desk at hsnhelpdesk@state.ma.us or (800) 609-7232 with questions.

HSN Help Desk

As of November 5, 2012, the email address for the HSN Help Desk will be changed to hsnhelpdesk@state.ma.us. Providers should no longer use the dhcfphelpdesk@state.ma.us email address. The phone number for the HSN Help Desk will remain the same at (800) 609-7232. 

835 Claims

835 Data Specifications - FINAL (Excel)  | Excel  | Excel  | Excel 

Other Information

• Covered Dental and DME HCPCS Codes (December 1, 2010) (PDF) 
• Payer Type and Payer Source Code List - Effective January 18, 2013 (PDF)  | Word 
• Covered Dental and DME HCPCS Codes (July 1, 2010) (PDF) 
• Covered Dental and DME HCPCS Codes (Feb. 6, 2009) (PDF) 
• Noncovered ICD9 Diagnosis Codes (Feb. 6, 2009) (PDF) 
• Noncovered ICD9 Procedure Codes (Feb. 6, 2009) (PDF) 
• Noncovered CPTs and HCPCS Codes ( Feb. 6, 2009) (PDF) 
• Noncovered Revenue Codes (Feb. 6, 2009) (PDF) 

SENDS-INET Instructions

Instructions: How to access your SENDS Updates for HSNO (PDF) 

INET Registration

Frequently Asked Questions for Hospitals

How should a hospital submit Dental claims to the HSN?

Dental claims must be submitted to HSN via the 837D claim format. Claims must be submitted via the Center for Health Information and Analysis (CHIA) web portal (INET), located at http://www.mass.gov/chia/provider/reporting-to-state/report-tools/.