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 176 June 2008 TO: All Providers Participating in MassHealth FROM: Tom Dehner, Medicaid Director RE: New MassHealth Card Introduction As part of the preparation for NewMMIS, MassHealth is issuing new member identification numbers and new MassHealth cards to all MassHealth members to help address HIPAA (Health Insurance Portability and Accountability Act) privacy and security concerns. New Number, New Card Each new MassHealth card will display the member’s name and a new 12-digit identification (ID) number. The new member ID number will not be based on the member’s social security number. The new member ID number will remain the same no matter how many times the member receives a replacement card, moves to another residence, has a change in name or marital status, or has a gap in MassHealth coverage. Additionally, following the practice of other health-insurance plans, MassHealth cards will no longer be issued at the head-of-household level. MassHealth cards will list only one member per card. Please remember that a MassHealth card does not guarantee eligibility for services. You must continue to verify eligibility on the date of service. New Card and REVS New MassHealth cards can be used immediately by MassHealth members. The existing Recipient Eligibility Verification System (REVS) will be modified to allow you to verify eligibility using the new 12-digit member ID number that will be printed on a new card. REVS will continue to allow you to check MassHealth eligibility using the member’s existing ID number or name, date of birth, and gender. At this time, please do not use the new member ID number for billing purposes. In an upcoming provider communication, we will let you know when you can begin using the new ID number for billing purposes. (continued on next page) New Card and REVS (cont.) Providers billing through the Pharmacy Online Processing System POPS) can use either the old or the new member ID number. Claims and prior authorizations not submitted through POPS require the use of the old member ID number. The MassHealth Card An image of the front and back of the new card appears below. Picture of front of card Picture of back of card When a member arrives at your office with a new MassHealth card, please start updating your records with the new MassHealth member ID number. While you will still be able to verify eligibility with a member’s existing identification number, the new MassHealth member ID number provides a greater level of privacy and security for MassHealth members. By updating your records, you will have taken an important and necessary step to prepare for the implementation of NewMMIS. New contact information on the back of the card Later this year, REVS will be consolidated into the NewMMIS MassHealth Provider Online Service Center. Toll-free numbers that were previously available to support REVS will change. The back of the new MassHealth card reflects this new information. Until you are notified in an upcoming communication, please continue to use the current toll-free number to contact REVS (1-800-462-7738). (continued on next page) MassHealth Members and the New Card Due to the large number of cards that need to be produced, MassHealth is issuing new cards by head of household or case, between July and September 2008. Consequently, not all members will get their new cards at the same time. MassHealth is making every effort to mail all cards associated with a household or case at the same time. While each member of a household will get his or her own card, MassHealth can only mail a maximum of four cards in one envelope, so a household may get more than one envelope. With a new MassHealth card, the member will receive an insert about the new card and the new MassHealth member number. A copy of this insert can be found at www.mass.gov/masshealth/newmmis and is attached to this bulletin. The insert informs members that each MassHealth member will now have his or her own card and that this new card replaces all previous MassHealth cards. The process to replace or request a new MassHealth card has not changed. To help ensure that MassHealth members receive their new card, please remind members that they must call MassHealth Customer Service if they have not yet reported an address change. MassHealth Members and the Old Card If a MassHealth member presents an old MassHealth card after he or she and the Old Card has received a new card, you can verify eligibility in REVS using the old MassHealth member ID number. When the new MassHealth Provider Online Service Center becomes active, you will continue to be able to verify eligibility using the old member ID number. Attachment The insert for the new MassHealth card is attached to this bulletin. Questions If you have any questions about the information in this bulletin, please contact MassHealth Customer Service at 1-800-841-2900, the REVS Help Desk at 1-800-462-7738, or e-mail your inquiry to revshelpdesk@eds.com. All Provider Bulletin 176 June 2008 Attachment Your new MassHealth card! You are receiving a new MassHealth card for each eligible member of your household. This envelope holds one or more MassHealth cards. Not all MassHealth members will get a new card at the same time. However, all members in the same household will get a new card at about the same time. Please follow the instructions in this letter for information on when and how to use this card. Picture of front of card PLEASE REMEMBER THAT THIS CARD ALONE DOES NOT GUARANTEE MASSHEALTH ELIGIBILITY. Why am I getting a new card? Each member will get his or her own MassHealth card. This helps to protect your identity and ensure a higher level of privacy for MassHealth members. This also follows a best-practice approach that is used by other health-insurance plans. The card will have your new 12-digit MassHealth ID printed on your card. Your old member ID will no longer appear on your MassHealth card. Use this new member ID to identify yourself to a health-care provider and when you call MassHealth Customer Service with any questions. Will my doctor accept this new card? Your new card replaces your old MassHealth card. Health-care providers have received a notice about this new MassHealth card. They have been told how to use the new card. Use this card right away. You can get more information about this new card at www.mass.gov/masshealth. If you have trouble using your card, call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss). If you are enrolled in one of MassHealth’s managed care organizations (MCOs), you will continue to use both your MCO card and the new MassHealth card. Your health-care providers must continue to contact the MCO Customer Service Center for inquires about your coverage with your MassHealth MCO. What do I do if I need to get my new MassHealth card replaced? Call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss) with any questions about your card or to get a new card. MH Card Insert (06/08)