06/23/14

MMQ SOFTWARE TO BE REMOVED FROM MASS.GOV BY JULY 31, 2014

Effective October 1, 2015, MassHealth will no longer support the proprietary Management Minutes Questionnaire (MMQ) software currently available to Nursing Facility providers on mass.gov/masshealth. By September 30, 2015, all providers using this software must transition to an alternative method of submitting MMQs.

Methods include:

  • Using the POSC (Provider Online Service Center) DDE (Direct Data Entry) MMQ functionality
  • Submitting MMQ batch files in accordance with MassHealth MMQ file specifications
  • Engaging a vendor to generate MMQ batch files

To facilitate this transition, MassHealth will remove the proprietary MMQ software from Mass.gov immediately after July 31, 2014.  If you would like to retain a copy of the software, please download it on or before July 31, 2014. MassHealth will provide support for the proprietary MMQ software until September 30, 2015, when all providers have transitioned to an alternative submission method.

POSC users may refer to the MMQ Job Aid available at www.mass.gov/eohhs/docs/masshealth/provlibrary/pocs-job-aids/sco-pace-submit-mmq.pdf. Batch submitters may view the MassHealth MMQ file specifications available at www.mass.gov/eohhs/docs/masshealth/provlibrary/draft-nf-d-icd-10.pdf. Both of these documents have been modified for ICD-10.

Thank you for your cooperation in making this important transition. MassHealth will keep you informed as the process moves forward. For questions, please contact MassHealth customer service by telephone at 1-800-841-2900 or by email at providersupport@masshealth.net.

 

ICD-10 TRADING PARTNER TESTING UPDATE

All providers that must test ICD-10 transactions with MassHealth are advised: MassHealth welcomes you to submit your test file to us any time you are ready. Although ICD-10’s implementation has been delayed until October, 2015, there is no need for you to wait until next year to participate in trading partner testing.

We encourage you to take advantage of testing availability times now!

To schedule a test date with the ICD-10 Testing Team, please contact MassHealth’s

EDI Department directly at 855-295-4047 or edi@mahealth.net.

 

IMPORTANT UPDATE FOR NURSING FACILITIES THAT RECEIVED REVALIDATION REQUEST LETTERS

As required by the Affordable Care Act, MassHealth is continuing its Provider Revalidation effort, and nursing facilities that were enrolled in MassHealth on or before March 25, 2011 have now received letters with instruction sheets advising them to revalidate all provider information online within 45 days of the date of the letter.

Please note that the instruction sheet was missing information regarding application fees as part of the revalidation process. Your nursing facility may be required to pay an application fee when revalidating, unless you have already made payment(s) to Medicare or another state (in which case you must provide proof).

For more information on Application Fees, please visit: www.mass.gov/eohhs/provider/insurance/masshealth/provider-application-fees.html

To make a payment, please go to www.paybill.com/MassHealthApplicationFeeBillPay/

MassHealth apologizes for any inconvenience. For more information, including All Provider Bulletin 242, a FAQ document and the Revalidation Job Aid, please visit the MassHealth Revalidation web page at www.mass.gov/eohhs/provider/insurance/masshealth/provider-enrollment. Click on Provider Revalidation.  For questions, please contact the MassHealth Customer Service Center at 1-800-841-2900 or by emailing providersupport@masshealth.net.

 


06/17/14

DO YOU NEED ASSISTANCE WITH REVALIDATION?  ONLINE TUTORIAL NOW AVAILABLE

MassHealth is now offering an online tutorial to all providers who have been mailed letters as part of the federally mandated Revalidation Initiative.  If you need assistance in completing the Revalidation process, this tutorial will provide you step-by-step instructions on how to:

  • Access your profile information on the POSC (Provider Online Service Center)
  • Make any changes/updates necessary to your provider profile
  • Download and complete any original signature documents that may be required

To access the tutorial, please go to the MassHealth Revalidation web page at www.mass.gov/eohhs/provider/insurance/masshealth/provider-enrollment.  Click on Provider Revalidation and go to Job Aids. The Revalidation page also offers you the All Provider Bulletin 242 and a Revalidation FAQ document. For questions, please contact the MassHealth Customer Service Center at 1-800-841-2900 or by emailing providersupport@mahealth.net.

 


06/10/14

NEW MASSHEALTH PUBLICATIONS POSTED ON THE WEB

MassHealth has posted the following publications on the MassHealth website:

Provider Bulletins from May 2014:

  • All Provider Bulletin 245: Behavioral Health Services for Members with Temporary MassHealth Coverage
  • All Provider Bulletin 244: Coverage Provided via Hospital-Determined Presumptive Eligibility
  • Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 5: NCCI Procedure-to-Procedure Code Pair Denial for Therapy Services

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

 


06/03/14

MASSHEALTH TIMEFRAMES FOR BILL PAYING FOR NURSING FACILITY PROVIDERS

MassHealth will be modifying the timeframes for paying Nursing Facility claims for May dates of service received by MassHealth in May or June. The payment schedule will be modified by approximately 2 weeks. Please see the modified payment schedule outlined below.

RA DATE: 07/01/2014

PAYMENT DATE CHECKS: 07/04/2014

PAYMENT DATE EFT: 07/07/2014

Claims for June dates of service will go back to the regular schedule. (Remittance Advice (RA) dated the third Tuesday of the month)

RA DATE: 7/15/2014

PAYMENT DATE CHECKS: 7/18/2014

PAYMENT DATE EFT: 7/21/2014

MassHealth is mindful of the difficulties imposed by fiscal management decisions and appreciates your patience and understanding.

 

ADJUSTMENTS FOR ACA SECTION 1202 RATES FOR PHYSICIANS WHO PROVIDE PRIMARY CARE

MassHealth has identified overpayments and, in some cases, underpayments of Calendar Year 2014 ACA Section 1202 rates on certain Evaluation and Management and Vaccine Administration claims submitted from January 1, 2014 to March 18,2014, due to a delay in the Section 1202 rates released by CMS. The enclosed remittance advice (and other remittance advices in the coming weeks) may contain claims processed from January to June that have been systematically adjusted to pay the corrected 1202 rate.

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

 

NEW MASSHEALTH PUBLICATIONS POSTED ON THE WEB

MassHealth has posted the following publications on the MassHealth website:

Provider Bulletins from May 2014:

  • All Provider Bulletin 244: Coverage Provided via Hospital-Determined Presumptive Eligibility

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