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 154 June 2006 TO: All Providers Participating in MassHealth FROM: Beth Waldman, Medicaid Director RE: Enhanced REVS Capabilities Background Effective June 2006, a number of new enhancements will begin to be offered in REVS. Please call the REVS HelpDesk with any questions at 1-800-462-7738 and select option 2, and then 5. Clarifying Senior Buy-In Coverage Based on provider feedback, MassHealth will now offer more detailed information for those members who are eligible under the Senior Buy-In coverage type. Today, REVS does not distinguish when a Senior Buy-In member is a Qualified Medicare Beneficiary (QMB), a Qualified Individual (QI), or a Specified Low Income Medicare Beneficiary (SLMB). This enhancement allows REVS to display these restrictive messages in the following circumstances: * Qualified Medicare Beneficiary (QMB) Restrictive Message: Member is Qualified Medicare Beneficiary. See 130 CMR 519.010. * Specified Low Income Medicare Beneficiary (SLMB) Restrictive Message: Member is SLMB Beneficiary. See 130 CMR 519.011(A). * Qualified Individual (QI) Restrictive Message: Member is QI Beneficiary. See 130 CMR 519.011(B). This change is applicable for all REVS access methods, which include WebREVS, REVSpc, Automated Voice Response (AVR) system, point-of-service (POS) terminals, eligibility operator, and third-party vendors. Buy-In Coverage REVS now displays two additional groups of members – Aged Specified Low Income Medicare Beneficiary (SLMB) Only and Disabled SLMB only. This change also enables authorized MassHealth providers who charge the Uncompensated Care Pool (UCP) for services associated with these members to view any associated UCP coverage these members may have. This change is applicable for all REVS access methods, which include WebREVS, REVSpc, Automated Voice Response (AVR) system, point-of-service (POS) terminals, eligibility operator, and third-party vendors. Expanded Name Search Capability The implementation of the expanded name search capability through the REVSpc software, Automated Voice Response (AVR) system, and third party vendors has helped reduce the number of calls you need to make to the REVS eligibility operator. The existing WebREVS site has also been modified to allow the expanded name search capability. Please refer to pages 3 and 4 of All Provider Bulletin 151 for how to take advantage of the expanded name search capability on WebREVS. Hospice Information REVS has been modified to display additional information when a member is enrolled in a hospice. This information will be displayed in the Third Party Liability (TPL) section of the REVS response. The additional information includes the date the member enrolled with the hospice provider, the end date (only when the date of service being inquired upon equals the last day the member is enrolled with the hospice), and the name, address, and phone number of the hospice provider. The chart below shows the changes discussed, with the bold, italicized text indicating that the field is new or that more detailed information is being provided in those fields. Member has Third Party Liability Coverage Type: HOSPICE Policy Number: XXXXXXXXX Carrier Number: XXXXX Hospice Start Date: 01/01/2006 Hospice End Date: 01/31/2007 (only displayed in certain cases.) Carrier Name: XXXXXXXXXXXXXXXXX Carrier Address: XXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX Phone Number: 111-111-1111 Please note that when no end date appears, that means that the member is currently enrolled with the hospice on the date of service being inquired upon. This change is applicable for all WebREVS, REVSpc, and third-party vendors only. 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.