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MassHealth Billing and Claims

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Billing Tips

In addition to the instructions outlined in your billing manual, MassHealth has compiled several informational leaflets that summarize procedures and policies.

They were created in response to providers' most commonly asked questions. We have used these billing tip sheets as part of our training programs for some time and they have received positive feedback. They may be downloaded and printed and are useful as a training tool for your staff.

Documents

Additional Resources for

Acute Hospitals – Billing Instructions for Carve-Out Drugs (PDF 406.96 KB)

Acute Hospitals – Billing Instructions for Carve-Out Drugs (DOCX 49.45 KB)

Billing instructions for LARC devices implanted inpatient, immediate post-partum effective March 1, 2018 (PDF 361.03 KB)

Billing instructions for LARC devices implanted inpatient, immediate post-partum effective March 1, 2018 (DOCX 36.04 KB)

Billing Instructions for Acute Inpatient Hospitals (PDF 400.77 KB)

Billing Instructions for Acute Inpatient Hospitals (DOC 45.5 KB)

Billing Tips for Methadone Code Changes (PDF 23.58 KB)

Billing Tips for Methadone Code Changes (TXT 3.75 KB)

Contact Information for MassHealth Claim Questions (PDF 100.25 KB)

Contact Information for MassHealth Claim Questions (DOCX 43.02 KB)

Correcting Errors 3120 and 3121 (PDF 17.31 KB)

Correcting Errors 3120 and 3121 (DOCX 14.41 KB)

Electronic Claims Submission (PDF 238.34 KB)

Electronic Claims Submission (DOCX 40.23 KB)

Home Health Billing Tips for Services Provided to Members Enrolled in a MassHealth MCO (PDF 21.29 KB)

Home Health Billing Tips for Services Provided to Members Enrolled in a MassHealth MCO (DOC 20.43 KB)

Hospice Billing Tips (PDF 22.67 KB)

Hospice Billing Tips (DOCX 15.07 KB)

Hospice Billing Tips for Room and Board Charges When a Member Is in a Long Term Care Facility (PDF 18.24 KB)

Hospice Billing Tips for Room and Board Charges When a Member Is in a Long Term Care Facility (DOCX 15.4 KB)

All Provider Bulletin 256: The Overpayment Disclosure Process (PDF 168.14 KB)

All Provider Bulletin 256: The Overpayment Disclosure Process (DOC 122 KB)

Suspense Edits for Nursing Facility Claims-Claim Conflict Suspense Edits (PDF 21.13 KB)

Suspense Edits for Nursing Facility Claims-Claim Conflict Suspense Edits (DOCX 16.21 KB)

Suspense Edits for Nursing Facility Claims-Level of Care Suspense Edits (PDF 15.9 KB)

Suspense Edits for Nursing Facility Claims-Level of Care Suspense Edits (DOCX 17.19 KB)

Suspense Edits for Nursing Facility Claims-Member Eligibility Suspense Edits (PDF 27.99 KB)

Suspense Edits for Nursing Facility Claims-Member Eligibility Suspense Edits (DOC 43.04 KB)

Tracking Claims Pended for Fiscal Reasons (PDF 116.96 KB)

Tracking Claims Pended for Fiscal Reasons (DOC 22.61 KB)

Understanding Accounts Receivables (PDF 20.9 KB)

Understanding Accounts Receivables (DOC 42.05 KB)

Using Remittance Advance(s) to Reconcile Your Accounts (PDF 25.38 KB)

Using Remittance Advance(s) to Reconcile Your Accounts (DOC 30.3 KB)

See all 34 See all of the resources for Billing Tips