MASSHEALTH ONLINE SERVICE CENTER
MassHealth is in the process of developing a new administrative system, known as New MMIS. This system will use an Online Service Center model to automate many of MassHealth's processes, and will change existing provider processes for eligibility verification, claims submission, referrals, and prior authorizations.
Here are some highlights of what's ahead: New Member ID numbers:
- All MassHealth members will be issued new 12 digit member ID numbers.
- Currently, families are issued one card. In the new process, there will be 1 card per member.
- The state will send new member cards out to all members. They aren't sure of the timeline for this mailing, but providers will be notified before it goes out.
- New 12 digit member ID numbers will begin showing in REVS in June, along with a member's existing RID#.
- New numbers will be required on bills, effective September 29th.
New Provider ID numbers:
- All MassHealth providers will be issued new 10 digit provider numbers.
- An additional character at the end will allow providers to differentiate up to 5 locations under the same provider number.
REVS:
Referrals:
REVS will be integrated into the Provider Online Service Center.
- Referral requests and approvals will be completed through the Provider Online Service Center.
- The system will general a 10 digit referral number, rather than using the primary care provider's ID number as the referral number.
Here is a link to the most recent provider bulletin on the New MMIS implementation. http://mass.gov/Eeohhs2/docs/masshealth/bull_2008/all-173.pdf
More information will be coming soon, especially related to the transitional activities prior to the roll-out, planned for September 29th. There are internal efforts underway to make sure that our operational processes can adapt to these changes and that our transactions with MassHealth work smoothly. There will also be some training opportunities announced soon, to take place in late spring/early summer. -Adapted from e-mail “New MassHealth system - New MMIS”, Kim Simonian, MPH, Community Benefit Programs, Partners HealthCare, April 15, 2008.
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