Commonwealth of Massachusetts Executive Office of Health and Human Services Division of Medical Assistance 600 Washington Street Boston, MA 02111 MassHealth Acute Outpatient Hospital Bulletin 2 November 2000 TO: Acute Outpatient Hospitals Participating in MassHealth FROM: Wendy E. Warring, Commissioner RE: Rebilling Denied Inpatient Admissions as Outpatient Services Background To assist acute hospitals to rebill certain denied inpatient admissions as outpatient claims, the Division is issuing the attached information sheet. This information pertains only to services billed on the UB-92 claim form. Information Effective June 11, 1999, for inpatient claims denied by MassPRO through the Prepayment and Postpayment Review Programs because of a lack of medical necessity for the inpatient setting, the Division allows acute hospitals to rebill these services as outpatient services (See 130 CMR 415.414 (B)). The Division has prepared the attached information sheet as an aid to hospitals preparing and submitting such outpatient claims. Please be sure to provide the attached information sheet to the departments that are responsible for rebilling the denied claims. Questions If you have any questions regarding preparing and submitting outpatient claims, please call the MassHealth Provider Services Department at (617) 628- 4141 or 1-800-325-5231.