Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
www.mass.gov/masshealth
	MassHealth
	All Provider Bulletin 223
	February 2012




	TO:	All Providers Participating in MassHealth

	FROM:	Julian J. Harris, M.D., Medicaid Director 

	RE:	Changes to Electronic Claims Submission Policy


Background	All Provider Bulletins 212 and 217 announced an important change in the
claims submission policy. Effective January 1, 2012, all MassHealth 
claims must be submitted electronically unless a provider has been 
approved for a temporary electronic claims submission waiver. This 
bulletin communicates two important updates on the following topics.
*	grace period for submitting paper claims without an approved 
electronic claims submission waiver; and
*	paper claims suspension.
	

Grace Period	MassHealth has established a grace period through March 31, 2012, to 
allow providers time to apply for the electronic claim submission waiver 
and complete electronic claim testing. Providers applying for a waiver will 
be notified about the status of their waiver application within 30 days. 
During this grace period, paper claims submitted by providers without an 
approved electronic claim submission waiver will continue to be 
processed.

A copy of the waiver request form is posted on the MassHealth Web site. 
From the home page, click on the link in the lower right corner for 
MassHealth Provider Forms and then click on Electronic Claims Waiver 
Request. Providers can also obtain a waiver request form by contacting 
MassHealth Customer Service at 1-800-841-2900 or 
providersupport@mahealth.net.
	

Paper Claims			Beginning on April 1, 2012, at the conclusion of the grace period, all 
Suspension 	paper claims submitted to MassHealth by providers who do not have an 
approved electronic claim submission waiver will suspend with Edit 
Code 819 - Paper Claim Submission under Review. MassHealth will 
review the claim(s) to determine if a waiver request form has been 
recently submitted. If a waiver request form has not been submitted and 
approved, the paper claim(s) will be denied with Edit Code 7750 - 
Paper Claim Not Allowed.
	
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Questions	If you have any questions about the information in this bulletin, or need 
help getting started with electronic claims submission, please contact 
MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to 
providersupport@mahealth.net, or fax your inquiry to 617-988-8974.



			MassHealth
			All Provider Bulletin 223
			February 2012
			Page 2