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POSC Job Aids

MassHealth has prepared a number of job aids as part of the POSC e-Learning courses. Beneath the name of each functional area listed below are links to the job aids associated with processes within those functional areas.

Provider Information & Navigation

• Provider Online Service Center Overview (PDF) 

Batch Claims Processing

• Download Batch Responses (PDF) 
• Upload Batch Files (PDF) 

Editing Claims Post Submission

• Copy a Claim Immediately (PDF) 
• Replace a Claim (PDF) 
• Resubmit a Denied Claim Immediately (PDF) 
• Void a Paid Claim (PDF) 
• Inquire on Claim Status (PDF) 

Eligibility Verification

• Submit Eligibility Inquiry (PDF) 
• Verify Member Eligibility (PDF) 

Health Safety Net (HSN)

• HSN Claims Migration to MMIS Overview 
• HSN Migration to MMIS 

HIPAA Pharmacy Claims

• HIPAA Pharmacy Claims (PDF) 

Managed Care

• Managed Care Providers 834 and 820 Submission and Download (PDF) 

Preadmission Screening

• Create a Preadmission Screening Request (PDF) 
• Inquire on a Preadmission Screening Request (PDF) 
• Re-review a PAS Request (PDF) 
• Modify a Preadmission Screening Request (PDF) 
• Extend a Preadmission Screening Request (PDF) 

Prior Authorization

• Create a Prior Authorization Request 
• Update or Void a Prior Authorization (PDF) 
• Complete a Saved Prior Authorization (PDF) 
• Inquire on a Prior Authorization Request (PDF) 
• Inquire on a Prior Authorization,View Status & Paid Claims (PDF) 
• Resubmit a Prior Authorization that is in a Cancelled Status (PDF) 
• Enter a Prior Authorization Request for PCM (Personal Care Management) (PDF) 
• Inquire/Maintain/Void a Prior Authorization for PCM (Personal Care Management) Providers (PDF) 

Provider Profile Maintenance

• Update Provider Profile (PDF) 
• Inquire on a Provider Profile Update Status (PDF) 

Provider Security

• Link Subordinate Accounts (PDF) 
• Change Password (PDF) 
• Create Subordinate Accounts (PDF) 
• Update Accounts (PDF) 

Referrals

• Submit Referrals (PDF) 
• Update Referrals (PDF) 
• Review Referrals (PDF) 

SCO/PACE

• Enroll in PACE (PDF) 
• Disenroll in PACE (PDF) 
• Enroll in SCO (PDF) 
• Disenroll in SCO (PDF) 

Submitting a Management Minutes Questionnaire

• Submit MMQ (PDF) 

Submitting Institutional Claims

• Institutional Claim Submission with MassHealth 

Submitting Professional Claims

• Professional Claim Submission with MassHealth 

Submitting Residential Care Home/Rest Home Claims

• Submit a Residential Care Home Claim (PDF) 

Third Party Liability (TPL)

• Supplemental Instructions for MassHealth Dual Eligible Members with Medicare Part B Coverage Only 
• Professional Claim Submission to MassHealth with Coordination of Benefits 
• Institutional Claim Submission to MassHealth with Coordination of Benefits 

View Metrics/Reports

• Accessing PCC Plan Enrollment Roster Report (PDF) 
• View Remittance Advice Reports (PDF) 
• View Metrics Reports (PDF) 

 

Important Note: The information on this page applies to all providers, except dental providers who are not oral or maxillofacial surgeons. Dental providers who are not oral or maxillofacial surgeons must contact the MassHealth Dental Customer Service Center at 1-800-207-5019 if they have any questions about MassHealth.

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This information is provided by MassHealth.