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.
- MassHealth Provider Library Bulletins
- Clinical Laboratory Services (August 1, 2014) | Word
- Surgery and Anesthesia (Rates effective March 1, 2018) | Word
Questions regarding these billing requirements should be directed to the MassHealth Customer Service at (800) 841-2900 or ProviderSupport@mahealth.net.
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 (800) 207-5019.
Other important HSN claims and payment information
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 Center at (800) 841-2900 or ProviderSupport@mahealth.net.
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 10th 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 email@example.com or (800) 609-7232 with questions.
HSN help desk
The HSN Help Desk email address is firstname.lastname@example.org. The phone number for the HSN Help Desk is (800) 609-7232.
- Covered Dental and DME HCPCS Codes (December 1, 2010) (PDF) | Word
- Payer Type and Payer Source Code List: Effective April 5, 2013 (PDF) | Word
- Noncovered CPTs and HCPCS Codes (Feb. 6, 2009) (PDF) | Word
- Noncovered Revenue Codes (February 6, 2009) (PDF) | Word