Eligibility Verification for MassHealth Providers

What you need   for Eligibility Verification for MassHealth Providers

• Your Provider Online Service Center (POSC) login information
• Your MassHealth Provider ID/Service Location Number
• The date(s) of service
• Any of the following member information:
  • 12-digit member ID
  • Social security number (SSN)
  • Other Agency ID (DCF and DYS)
  • First name, last name, date of birth, and gender

How to check   Eligibility Verification for MassHealth Providers

Online +

1. Access member eligibility information from the EVS Internet site through the POSC.
2. Click Manage Members.
3. Click Eligibility.
4. Click Verify Member Eligibility. The Check Member Eligibility panel is displayed.
5. On the Check Member Eligibility panel, select the provider from the drop-down list.
6. Enter either the member's:
   • 12-digit Member ID
   • SSN
   • Other Agency ID (DCF and DYS)
   • First name, last name, DOB and gender
7. In the From Date of Service and To Date of Service fields, enter the date range for the search.
8. Click Submit.
9. On the Member Information tab: Confirm the member’s information.
10. Once you have confirmed the member’s information, click the Eligibility tab.
11. On the Dates of Eligibility panel, click Verify Eligibility Status.
12. After verifying the member’s eligibility status, do one of the following:
    • To end the process, click Close.
    • To verify another member’s eligibility, click Perform Another Eligibility Check.
13. Click the "print" button on your browser to print a paper copy of the member's eligibility verification. Save this for your records.

Downloads   for Eligibility Verification for MassHealth Providers

Open PDF file, 517.82 KB,  MassHealth MMIS Job Aid: Verify Member Eligibility (English, PDF 517.82 KB)

Open DOCX file, 1.34 MB,  MassHealth MMIS Job Aid: Verify Member Eligibility (English, DOCX 1.34 MB)

Contact   for Eligibility Verification for MassHealth Providers

MassHealth Customer Service for Providers

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Address

P.O. Box 278, Quincy, MA 02171

Directions 

Phone

Main: Call MassHealth Customer Service for Providers, Main: at (800) 841-2900

Open Monday–Friday 8 a.m.–5 p.m.

TTY/TDD: Call MassHealth Customer Service for Providers, TTY/TDD: at 711

Online

Email Email MassHealth Customer Service for Providers at provider@masshealthquestions.com

Fax

(617) 988-8974

Related

• Eligibility Verification System Overview 
• MassHealth Copayment Information for Providers  
• MassHealth Member File Maintenance