Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth Eligibility Operations Memo 08-14 September 15, 2008 TO: MassHealth Eligibility Operations Staff FROM: Russ Kulp, Director, MassHealth Operations RE: New MassHealth Card Introduction As part of the preparation for NewMMIS, MassHealth is issuing new member identification numbers and new MassHealth cards to help address HIPAA (Health Insurance Portability and Accountability Act) privacy and security concerns. New Number, New Card Each new MassHealth card will display the member’s name and a new 12-digit identification number. The new member ID number will not be based on the member’s social security number. The new member ID number will remain the same no matter how many times the member receives a replacement card, moves to another residence, has a change in name or marital status, or has a gap in MassHealth coverage. Additionally, following the practice of other health-insurance plans, MassHealth cards will no longer be issued at the head-of-household level. MassHealth cards will list only one member per card. New Card and REVS New MassHealth cards can be used immediately by members. The existing Recipient Eligibility Verification System (REVS) will be modified to allow providers to verify eligibility using the new 12-digit member ID number that will be printed on a new card. REVS will continue to allow providers to check MassHealth eligibility using the member’s existing ID number or name, date of birth, and gender. Later this year, REVS will be renamed Eligibility Verification System (EVS). (continued on next page) The MassHealth Card An image of the front and back of the new card appears below. (picture of front of card) (picture of back of card) MassHealth Members and the New Card Due to the large number of cards that need to be produced, MassHealth is mailing new cards based on the head of household or case, between October and December 2008. During this time, legacy cards will still be produced for certain members who have not yet received the new card. All members will eventually receive a new card, however they may receive a legacy card first. Not all members will get their new cards at the same time. Every effort is being made to mail all cards associated with a household or case at the same time. A maximum of four cards can be mailed in one envelope, so a household may get more than one envelope. With a new card, the member will receive an insert about the new MassHealth card and the new MassHealth member number. A copy of this notice is attached to this memo and can be found at www.mass.gov/masshealth/newmmis. (continued on next page) Card Replacement Requests For staff who can submit card replacement requests, how and where Requests you request the replacement card has not changed, but some procedures of submitting the request have. As cards are mailed, both new and old card replacements will be handled simultaneously in REVS. As a result, the REVS Card Inquiry/Update (CA) screen will be modified. New features on the REVS Card Inquiry/Update screen include * display of the NewMMIS ID number; * ability to request replacement cards for new MassHealth ID cards with the NewMMIS member ID number; * mailing date of a NewMMIS MassHealth card; and * identification of the address to which a NewMMIS MassHealth card was sent. The CA screen will be enhanced to allow MassHealth Customer Service (CST), MassHealth Operations, and the MassHealth Enrollment Centers (MECs) to request cards for MassHealth members using NewMMIS member ID numbers or the card number, as is currently done. The CA screen will appear the same, except there will be an additional field named NMMIS mail date. This date indicates when a new MassHealth card with the NewMMIS member ID number has been mailed. A mail date will be provided for each eligible individual on file in that household. If there is no date in this field, a NewMMIS MassHealth card has not yet been mailed. The process for requesting replacement cards for all members currently listed on a single card has been modified. You must now request a replacement card for each eligible member in the household. This process is explained in the attached NewMMIS MassHealth Card Replacement Instructions. Member Calls Staff who receive member calls about cards should be prepared to handle questions about the new card. Below are instructions about handling these calls: If a member calls because he or she did not receive a new card 1. Check member eligibility. If the member is eligible for a card-carrying aid category, proceed to step 2. If the member is not eligible for a card- carrying aid category, explain that the member does not receive a card. (continued on next page) Member Calls (cont.) 2. Check the REVS Card Inquiry/Update (CA) screen to see if the mailing date of a NewMMIS MassHealth card field is blank. If the field is blank, tell the member about the new card time frame and encourage the member to continue using his or her current card. If the field has a date, check the address to which a NewMMIS MassHealth card was sent. If the address is correct, tell the member that it may take 10-14 days for the card to be received. The member should call the CST if the card has still not been received after 10-14 days. If the address is not correct, change the address in MA21 and request a new card through this screen the following day. If everyone in the member’s household did not receive card 1. Ask who in the family did not receive a new card. Check to see if the member is on the same case and if the member is eligible for a card carrying aid category. If the member is eligible and on the same case, look up the member in REVS to see if a new card was issued. 2. Explain to the member that every attempt will be made to send cards to the same household at the same time and follow the instructions above under the section If a member calls because he or she did not receive a new card. If the member name is misspelled Correct name in MA21 or appropriate eligibility system and request a replacement card through the REVS Card Inquiry/Update screen. MassHealth Members and an Old Card If a MassHealth member presents an old card after he or she has received a new card, a provider can verify eligibility in REVS or the new MassHealth Provider Online Service Center (when it becomes available) using the old MassHealth member ID number. Attachments The following documents are attached to this memo: * instruction for replacing a MassHealth card; and * the member insert for the new MassHealth card. Questions If you have any questions about this memo, please have your MEC designee contact the Policy Hotline. EOM 08-14 September 15, 2008 Attachment 1 Page 1 NewMMIS MassHealth Card Replacement Instructions When using the REVS Card Inquiry/Update Screen (CA screen), it is important to first determine if you are inquiring about a current MassHealth card number or a NewMMIS Member ID number. Depending on which card you are using, responses on the CA screen differ. The message in red on the CA screen will be the new initial message. A card can be requested by either entering the card number or the NewMMIS ID number. DATE: 04/13/2008 MASS REVS TIME: 19:10:03 CARD INQUIRY/UPDATE SCREEN SESSION ID CA MESSAGE ENTER REVS CARD NUMBER OR NEW MMIS ID NUMBER CARD NUMBER CARD STATUS RECORD ACTION I CARD REQUEST DATE CARD DIST DATE RECIPIENTS 01 02 03 04 CARD WAS MAILED TO: CARD REPLACEMENT CARD REPLACEMENT REASON CARD ISSUE REASON INVALIDATE CARD INVALIDATE CARD REASON CARD INVALID DATE If you have a current 10-digit MassHealth card number, follow the directions for the 10-digit card number. If you have a 12-digit NewMMIS MassHealth card number, follow the directions for the 12-digit card number. EOM 08-14 September 15, 2008 Attachment 1 Page 2 Instructions for the 10-digit MassHealth card number Step 1: At the REVS Card Inquiry/Update Screen (CA screen), enter the 10 digit MassHealth Card number on the Card/ID Number provided line below Session ID and press Enter. The member or members will appear on the CA screen. Step 2: TAB to the Record Action field at the top right of the screen. Change the ‘I’ to a ‘C’ (change). Press the Enter key. The first name, last name, Recipient ID/Case ID number, and NMMIS mail date will appear for the member or members on the card. The NMMIS mail date indicates if a NewMMIS MassHealth card has been issued to the member. There are two scenarios when requesting a card using the MassHealth card number. Scenario 1: If you are requesting a card and you do not see a date in the NMMIS mail date for the member, he or she will receive an old MassHealth card listing all the members shown on the CA screen. If there are no NMMIS dates shown, the card requesting procedure remains the same as it has been. Scenario 2: If one or more members show the NMMIS mail date beside their member ID (RID) number, the member who requested the card will receive either an old or a new MassHealth card depending on the date (see Note below). If NMMIS dates are visible, continue to follow the steps below the following Note. Note: Whether the member receives a NewMMIS card or an old MassHealth card depends on if there is a mail date on the right side of the RID number. If the member you have selected has a NMMIS mail date showing, he or she will receive a NewMMIS MassHealth card with only this or her name and ID listed on the card. If the member you have selected does not have a NMMIS mail date showing, then that member will receive an old MassHealth card with all of the members showing on the CA screen on that card. Step 3: TAB until the cursor is on the left side of the specific member who requested a MassHealth card. Mark an ‘X’ to indicate this person needs to be sent a replacement card. Repeat for each members who needs a card. Step 4: Fill out the applicable fields on the bottom of the CA screen: card replacement, card replacement reason, invalidate card, and invalidate card reason. Press Enter. Step 5: The message at the top, center of the CA screen will now say either “NO ERRORS - PRESS PF6 TO UPDATE FILE” or “NMMIS CARD FILE – WRITE OK.” Press F6 to save your changes and request the card or cards. EOM 08-14 September 15, 2008 Attachment 1 Page 3 Note: If you do not press F6, your changes will not be saved and the card will not be requested. If a 10-digit card MassHealth number is entered, the worker should check REVS card file and display the details. This screen is modified to allow a worker to select which members should get a new card, as shown by the X on the edge of the screen. DATE: 04/14/2008 MASS REVS TIME: 08:39:04 CARD INQUIRY/UPDATE SCREEN SESSION ID CA MESSAGE RECORD FOUND - PLEASE REVIEW DATA CARD/ID NUMBER 8500000000 CARD STATUS 1 RECORD ACTION I CARD REQUEST DATE 12/05/1988 CARD DIST DATE 12/05/1988 Act Seq Case/ Name REVS Case/Recip ID NMMIS mail date X 01 TEST A CARD MM1234567 9 maildate X 02 TEST A B MM1234560 1 maildate X 03 TEST B A MM1234500 8 maildate X 04 TEST C MM1234000 6 maildate CARD WAS MAILED TO: TEST A CARD 180 TREMONT STREET BOSTON MA 021090000 CARD REPLACEMENT CARD REPLACEMENT REASON CARD ISSUE REASON I INVALIDATE CARD INVALIDATE CARD REASON CARD INVALID DATE EOM 08-14 September 15, 2008 Attachment 1 Page 4 Instructions for the 12-digit MassHealth card number Step 1: At the REVS Card Inquiry/Update Screen (CA screen) you have the option to enter either the MassHealth card number or the NewMMIS member ID number. Enter the 12-digit NewMMIS ID number on the line where it says Card/ID Number (below Session ID) and press Enter. Step 2: After entering the NewMMIS member ID, there are two scenarios that are possible. Scenario 1: If you have entered the member’s NewMMIS ID number and the member does not appear on the CA screen, but an error message is shown saying “NMMIS CARD NOT MAILED,” this means that the member has not yet received a NewMMIS MassHealth card and cannot be found using the NewMMIS ID number. As a result, you can inquire for this member only using the 10-digit card number. Scenario 2: If you have entered the member’s NewMMIS ID number and the member does appear on the CA screen, you will be able to request a new card for the member using their NewMMIS ID number. Continue to follow the instructions below. Step 3: The member who is associated with the entered NewMMIS ID appears on the CA screen. TAB to the Record Action field and change the ‘I’ to a ‘C’ (change). Press the Enter key. Note: The NMMIS mail date field shown on this screen should be identical to the distribution date. Both dates identify when the NewMMIS card was mailed out. Also shown is the address where the NewMMIS card was mailed on that distribution date. When inquiring by NewMMIS ID number, the address for this member may be different when inquiring by the card number. This is the result of system conversion processes for NewMMIS. Step 4: Fill out the applicable fields on the bottom of the CA screen: card replacement, card replacement reason, invalidate card, and invalidate card reason. Press Enter. Step 5: The message at the top, center of the CA screen should now say “NO ERRORS - PRESS PF6 TO UPDATE FILE.” Press F6 to save your changes and request the card or cards. Note: If you do not press F6, your changes will not be saved and the card will not be requested. EOM 08-13 September 15, 2008 Attachment Your new MassHealth card! You are receiving a new MassHealth card for each eligible member of your household. This envelope holds one or more MassHealth cards. Not all MassHealth members will get a new card at the same time. However, all members in the same household will get a new card at about the same time. Please follow the instructions in this letter for information on when and how to use this card. Picture of front of card PLEASE REMEMBER THAT THIS CARD ALONE DOES NOT GUARANTEE MASSHEALTH ELIGIBILITY. Why am I getting a new card? Each member will get his or her own MassHealth card. This helps to protect your identity and ensure a higher level of privacy for MassHealth members. This also follows a best-practice approach that is used by other health-insurance plans. The card will have your new 12-digit MassHealth ID printed on your card. Your old member ID will no longer appear on your MassHealth card. Use this new member ID to identify yourself to a health-care provider and when you call MassHealth Customer Service with any questions. Will my doctor accept this new card? Your new card replaces your old MassHealth card. Health-care providers have received a notice about this new MassHealth card. They have been told how to use the new card. Use this card right away. You can get more information about this new card at www.mass.gov/masshealth. If you have trouble using your card, call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss). If you are enrolled in one of MassHealth’s managed care organizations (MCOs), you will continue to use both your MCO card and the new MassHealth card. Your health-care providers must continue to contact the MCO Customer Service Center for inquires about your coverage with your MassHealth MCO. What do I do if I need to get my new MassHealth card replaced? Call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss) with any questions about your card or to get a new card. MH Card Insert (06/08)