Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth All Provider Bulletin 151 March 2006 TO: All Providers Participating in MassHealth FROM: Beth Waldman, Medicaid Director RE: Enhancements to WebREVS New Look for WebREVS In late March 2006, the Web site where you verify eligibility for MassHealth members, www.massrevs.eds.com, also referred to as WebREVS, will be modified to be similar in appearance to our other Web pages located at www.mass.gov/masshealth. This change provides a consistent look and similar functionality for all MassHealth Web processes. You will now be able to navigate our Web site with greater ease. Enhancements The functionality that you have experienced with WebREVS up to now will remain intact within the new appearance of WebREVS, but we will add some new features that will help reduce the time it takes to verify eligibility. These changes are described below. Expanded Name Search Functionality We will enhance the name-search function so that you will be able to enter up to 20 characters of the member’s last name and up to 15 characters of the member’s first name, along with the member’s date of birth and gender for an exact match. In addition to the exact match, this enhancement will let you search by name through a phonetic match (using the “soundex” algorithm) when the exact name is not available. Please see the attachment to this bulletin for the specific steps to use for this expanded name-search capability. Login and Change Password Pages We will move the password-change feature from the Login page to a new Change Password page. This function will be available as a new menu option, after you log in to WebREVS. WebREVS will continue to provide the automatic user prompt to change the password if the password has expired or if you are logging in to WebREVS for the first time. (continued on next page) Enhancements (cont.) Location of WebREVS Menu Options The menu to select various functions on WebREVS will be located on the right side of the screens, to match the conventions in the other MassHealth Web pages. Options to Enter Date of Service and Date of Birth The date-of-service and date-of-birth fields on the eligibility verification and claim status pages will let you enter the date directly, instead of by selecting the date from a list of values. We will also add a calendar feature, so you can select the date by clicking on the desired date on the calendar. Eligibility Verification Page The data fields associated with the name search feature will appear beneath the member ID to verify eligibility. We decided to move these fields because the name search feature is one of the more popular methods of verifying eligibility. Claim Status Inquiry Page We will move the member name, date of birth, and gender information to the “Additional Member Information” section on the Claim Status Inquiry page (since REVS does not use this information to retrieve claims). These fields will be set to default values so that you will no longer need to enter this information. This enhancement should reduce the amount of time you spend verifying the status of claims. Attached Flyer Attached is a flyer that is intended as a quick-reference set of instructions for verifying MassHealth eligibility by member name. We have provided this flyer as a training aid for you and your staff as you encounter the new enhancements to REVS. Questions If you have any questions about the information in the bulletin, please call the REVS HelpDesk at 1-800-462-7738. Select option 2, then option 5. MassHealth All Provider Bulletin 151 March 2006 Attachment Page 1 Steps for Verifying Eligibility by Member Name (available on all REVS access methods, except the point-of-service (POS) terminals) Expanded Name Search Capability To ensure a higher success rate of finding a member on REVS, you can now enter up to 20 characters of the member’s last name, up to 15 characters of the member’s first name, the member’s date of birth, and the member’s gender. If the member’s name is John Smythe and he was born on May 1, 2005, REVS performs the following steps. 1. You can continue to verify member eligibility by entering the first five characters of the member’s last name, first initial, date of birth, and gender. However, to take full advantage of the name-search capability, we recommend that you enter the member’s entire name, where possible. Based on the data entered, REVS will then do the following. * If the last name is five or fewer characters, enter all characters for that name. * If the last name is greater than five characters, enter up to 20 characters of the last name. REVS first attempts to match the member (for example, John Smythe who is a male with a date of birth of May 1, 2005) based on the following criteria: * last name – Smyth (first five characters of the last name) * first name – J * date of birth – May 1, 2005 * gender – M 2. If REVS does not find a match based on the name-search criteria outlined in the previous section, then REVS will attempt to match the member’s entire last name, first name, date of birth and gender. * last name – Smythe * first name – John * date of birth – May 1, 2005 * gender – M Please note that when a member’s last name contains more than five characters, then all characters of the member’s last name must be entered to achieve a successful name match based on the entire name. For example, if the member has a last name containing 15 characters and only 10 characters are entered, REVS will interpret the 10 characters as the member’s entire last name. Partial-name searches (outside of the criteria listed in Step 1) will not result in a successful match. In situations where the member’s last name contains more than 20 characters or the first name contains more than 15 characters, REVS will match on the exact spelling of all characters entered. MassHealth All Provider Bulletin 151 March 2006 Attachment Page 2 If a member’s name is not matched based on the exact spelling of the member’s name, date of birth and gender, then REVS will make one additional attempt to match your name search eligibility verification inquiry using a phonetic match. (See page 2 of this attachment.) Expanded Name Search Capability – Phonetic Match If REVS is not able to find a member by how the provider entered the name on REVS, REVS will then attempt to match the data entered by how the member’s name sounds, also referred to as a phonetic match. This phonetic match is used when a member is not found using the exact name text entered on REVS by the provider. For example, since “Smythe” can be pronounced as “Smith,” REVS will search for any members as follows: * last name – sounds like ‘Smith’ * first name – sounds like ‘John’ * date of birth – May 1, 2005 * gender – M If REVS finds a successful match based on how the member’s name sounds, then a response will be returned. If REVS does not find a match based on the previous search criteria, the message “Member not found” will be returned. If REVS finds multiple matches based on the previous search criteria, the message “Duplicate RID – Call Eligibility Operator at 1-800-833-7582” is returned. This is the same process that happens today. Questions If you have any questions about the REVS search features, please call the REVS HelpDesk at 1800462-7738. Select option 2, then option 5.