HSN claims and payment information

This page provides information about MMIS claims submission and other HSN claims and payment information.

MMIS claims submission

Providers should submit HSN claims in accordance with the Medicaid Management Information System (MMIS) billing requirements unless specifically noted otherwise in the HSN Billing Guides. Below are links to MassHealth regulations and All Provider Bulletins that providers can refer to for assistance.

Special Circumstances Web Application User Guide (PDF) | Word

837P Billing Guide (PDF) | Word

837I Billing Guide (PDF) | Word

• MassHealth Provider Library Bulletins
• Clinical Laboratory Services
• Surgery and Anesthesia

Questions regarding these billing requirements should be directed to the MassHealth Customer Service at [phone] or [e-mail].

HSN dental claims

Effective January 1, 2017, all HSN dental claims should be submitted to the HSN’s third party vendor, DentaQuest. Providers should make certain that any claims with date of service from January 1, 2017, forward, are submitted to DentaQuest. If you have questions, please contact DentaQuest HSN Customer Service at [phone].

Other important HSN claims and payment information

Duplicate claims

Under no circumstances should duplicate claims ever be submitted. Resubmission of previously paid claims should always be submitted as an adjustment, never as an original claim, and should occur only when a change to submitted claims data is warranted. Providers with questions regarding this communication should contact the MassHealth Customer Service at [phone] or [e-mail]

Payer of last resort

HSN is always a payer of last resort. If an individual has other insurance or coverage including but not limited to:

• Commercial insurance,
• MassHealth (including Children’s Medical Security Plan and Limited),
• Medicare, or
• Coverage through the Health Connector,

Providers must bill an individual’s primary insurance prior to billing the Health Safety Net.

HSN payment schedule

The HSN claim payment period includes refresh and payment cycles based on the following.

• HSN payment period continues to be based on the calendar month that HSN claims were submitted and processed (e.g., November),
• HSN refresh period will begin at the beginning of a month and be based on claims submitted during the previous payment period (e.g., a December refresh would be based on a November payment period),
• HSN remittances will be posted on INET by the 10^th of a payment month (using the timeline above, remits would be posted on INET by January 10), and
• HSN payments will be released by the end of a payment month (using the timeline above, payment would be released by January 31).

Providers should contact the HSN Help Desk at [e-mail] or [phone] with questions.

HSN help desk

The HSN Help Desk email address is [e-mail]. The phone number for the HSN Help Desk is [phone].

SENDS-INET instructions

Additional Resources

Instructions: How to access your SENDS updates for HSNO

Instructions: How to access your SENDS updates for HSNO