MassHealth requires Primary Care Clinicians (PCCs) to refer members enrolled in the PCC plan to specialty 
providers when members require services that cannot be performed by the provider. This job aid shows how to:
*	Submit a referral for a specialty provider
*	Use the Search for Provider function to locate a specialty provider
Access Enter New Referral
From the Provider Online Service Center home page:
1.	Click Manage Service Authorizations.
2.	Click Referrals.
3.	Click Enter New Referral. The Referral Information panel is displayed.
Enter Member and Provider Information
On the Referral Information panel:
4.	Enter the Member ID.
5.	Select the Referring Provider from the drop-down list.
6.	In the Service Provider field, click the Field Search button ( ) to display the Search for Provider 
panel, where you can perform a search for the correct service provider.
Search for Referring Provider
On the Search for Provider panel:
7.	Enter the search criteria for the service provider.
	Note:  For effective searching, enter as much search information as possible. You can search for 
service providers using one or more of the following search criteria:
*	Business Name
*	Provider’s Last Name
*	Provider’s First Name
*	Gender
*	City
*	ZIP Code
*	Provider ID or NPI
*	Specialty
*	Provider Type
8.	Click Search. The List of Servicing Providers panel is displayed.
Note: The current NewMMIS provider search capability within the SA subsystem is limited.  It does not 
provide search results such as a physician who is board certified in cardiology.  It only provides 
specialties such as nursing homes, abortion services, etc.  You must use the current business 
process/methods to identify board certified specialists through your own network of providers.

Select Referring Provider
On the List of Servicing Providers panel:
9.	Click the Name link of the desired service provider.  The Referral Information panel is displayed, and 
the selected provider’s name appears in the Service Provider field.
Enter Referral Details and Submit
On the Referral Information panel:
10.	In the Assignment field, select the type of referral from the drop-down list.
11.	Enter a Diagnosis Code (Optional).
12.	Enter a Reason for Referral (Optional).
13.	Enter the Effective Date of the referral.
14.	Enter an End Date for the referral.
Note:  When an Effective Date is entered, the End Date field is automatically populated with a date 
one year from the Effective Date, but it can be modified if necessary.
15.	In the Visits field, enter the total number of authorized visits to the service provider.
16.	Once you have the entered all the required information, click the Submit button. A Referral 
Confirmation panel is displayed, indicating that you have successfully submitted the referral.

NewMMIS Job Aid: Submit a Referral
MassHealth Provider Online Service Center	1 of 2	Revised: July 27, 2010
		v2.2
Provider Online Service Center - Submit a Referral
MassHealth Provider Online Service Center 	Submit a Referral	1/3