02/25/14

ATTENTION ELECTRONIC CLAIM SUBMISSION WAIVERED PROVIDERS: NEW 1500 CLAIM FORM REQUIRED AS OF MARCH 22, 2014

On June 17, 2013, the National Uniform Claim Committee (NUCC) announced the approval of the 02/12 version of the 1500 Health Insurance Claim Form (1500 Claim Form). The new form accommodates reporting needs for ICD-10 and aligns with requirements in the Professional (837P) Version 5010 Technical Report Type 3. On April 1, 2014, payers will be required to process paper claims submitted only on the revised 1500 Claim Form.

To accommodate this April 1, 2014 deadline, providers who have been approved to submit paper claims are advised that MassHealth will only accept the previous 08/05 version of the 1500 form until March 21, 2014. Any 08/05 version of the form received after that date will be returned to the provider. Providers must begin submitting paper claims on the revised 1500 Claim Form as of March 22, 2014.

For more information on the changes made to the form, please visit the NUCC website at www.nucc.org. MassHealth will also provide additional information as it becomes available. For questions, please contact MassHealth Customer Service at 1-800-841-2900 or providersupport@mahealth.net.


02/18/14

PROVIDER RATE CHANGE FOR PROCEDURE CODE 88112

On November 18, 2013, MassHealth updated the rate for procedure code 88112 for provider types 80 (Acute Outpatient Hospital) and 81(Hospital Licensed Health Centers) retroactive to 07-01-12.

Any claims which were adjudicated with dates of service 07/01/2012 and after will be systematically adjusted to pay correctly. The adjustments may appear on this or a future Remittance Advice.

We apologize for any inconvenience this may have caused. For questions, please contact MassHealth Customer Service at providersupport@mahealth.net or call 1-800-841-2900.

 

PROVIDER BILLING REMINDER: CARCS AND RARCS HAVE CHANGED

Providers are again reminded that CARCs (Claims Adjust Reason Codes) and RARCs (Remittance Advice Remark Codes) have changed, as required by ACA (Affordable Care Act) Operating Rules. To view the new CARCs/RARCs list, go to www.mass.gov/masshealth/aca, and then click on ACA Operating Rules.

Providers are also reminded to update business processes. Please contact your financial institution to ensure it supports the new CCD+ Addenda file format used to transmit payment information.

For questions, please contact MassHealth Customer Service at 1-800-841-2900 or providersupport@mahealth.net.


02/04/14

CMS ICD-10 READINESS SURVEY FOR SPECIALTY PROVIDERS

CMS (the Centers for Medicare and Medicaid) is requesting that providers across the country complete its ICD-10 Readiness Survey. This will help CMS gauge provider readiness for the ICD-10 transition.

Please take this online survey at https://www.surveymonkey.com/s/ICD-10_Provider_Readiness_CMS. It takes less than ten minutes to complete and your responses will remain anonymous. Please submit your entry by February 10, 2014.

For questions, please contact MassHealth Customer Service at 1- 800-841-2900 or providersupport@mahealth.net.

 

MASSHEALTH ICD-10 READINESS SURVEY – DEADLINE EXTENDED

MassHealth has extended the deadline for providers to take the online ICD-10 Readiness Survey to Monday, February 10, 2014.

The Readiness Survey will gather key information that will allow MassHealth to better anticipate the needs of our providers, billing intermediaries, clearinghouses and software vendors as we all prepare for ICD-10 implementation.

Please complete the ICD-10 Readiness Survey at http://webapps.ehs.state.ma.us/reviewsurvey/ReviewSurvey.aspx?id=381. Please make every effort to review and submit your entry by February 10, 2014.

For questions, please contact MassHealth Customer Service at 1- 800-841-2900 or providersupport@mahealth.net.

 

MMQ SOFTWARE CHANGES COMING IN OCTOBER 2014

Effective 10/1/14, MassHealth will no longer support the proprietary MMQ software currently available on mass.gov/masshealth. All providers currently utilizing this software must transition to the MMQ direct data entry functionality on the POSC or generate an MMQ file in accordance with the MMQ file submission specifications prior to 9/30/14.

MassHealth is currently updating the specifications to include the ICD-10 modification and will notify you once they are available. MassHealth will continue to keep you informed of this important transition.

 

NEW MASSHEALTH PUBLICATIONS POSTED ON THE WEB

MassHealth has posted the following publications on the MassHealth website:

Provider Bulletins from January 2014:

  • All Provider Bulletin 241: Information about ICD-10-CM/PCS

Provider Transmittal Letters from January 2014:

  • COH-8: New Subchapter 6

You can download a copy of a Bulletin or Transmittal Letter from the online Provider Library (www.mass.gov/masshealthpubs).


This information is provided by MassHealth.