This tool is meant to provide MassHealth network providers a basic understanding of topics such as member eligibility, claims, provider regulations and integrity expectations that will aid providers in conducting business with MassHealth.
- This page, MassHealth Provider Handbook, is offered by
- MassHealth
Handbook MassHealth Provider Handbook
| Organization: | MassHealth |
|---|---|
| Date published: | July 29, 2022 |
Welcome
Thank you for joining the MassHealth Provider Network! This MassHealth Provider Handbook page is intended for both new and existing providers. It provides a general overview of MassHealth provider requirements and expectations and includes resources to aid in serving MassHealth members. While this handbook page touches on many subjects, it is not the sole source of information for these topics. It should be used as a reference tool that will help point you to more additional detailed information. At the end of this page is a PDF version that can be downloaded.
Table of Contents
- Fee-For-Service (FFS) and MassHealth Provider Network
- Types of MassHealth Network Providers
- MassHealth Provider Directory, Provider File Maintenance, and Revalidation
- Provider Manuals & Regulations
- Provider Integrity
- MassHealth Members and Benefits
- Third Party Liability (TPL)
- MassHealth Authorizations and Referrals
- MassHealth Electronic Data Interchange (EDI)
- Payments
- Mass.gov for MassHealth Providers
- Provider Portals
- Provider Resources and Communications
- Appendix A: Acronyms
Downloads
Open PDF file, 10.28 MB,
MassHealth Provider Handbook
(English, PDF 10.28 MB)