Temporary HSN through a Presumptive Determination (HSN-PD) is a new, optional application process that was created in the HSN Eligible Services Regulation that was adopted on April 8, 2016 (101 CMR 613.04(2)(4)). Its intent is to offer an alternative channel to access the HSN on an immediate but temporary basis in cases where the patient cannot fill out a full application on the date of service, to ensure that HSN providers will be able to bill for eligible services, and to provide individuals a bridge to connect them to longer-term eligibility and coverage options.
To learn more about the application and the process to submit applications, facility staff should review the training below by reading the slides and listening to
accompanying audio in the YouTube video below.
- Health Safety Net Presumptive Determination Training (PDF) | PPT
- Application for Health Safety Net (HSN) Presumptive Determination (PDF) | Word
- HSN Presumptive Determination Approval Letter (PDF) | Word
- HSN Presumptive Determination Denial Letter (PDF) | Word
- Health Safety Net Presumptive Determination Fax Cover Sheet (PDF) | Word