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Can you be denied MassHealth?

Decisions made by Medicaid, known as MassHealth in Massachusetts, can be challenged. If you applied for MassHealth as part of the process for getting into a nursing home and were denied MassHealth, you have the right to appeal the denial.

How do I appeal a MassHealth denial?

How to appeal By mail + Fill out the Fair Hearing Request Form. Make a copy for yourself. Send a copy to the Office of Medicaid, Board of Hearings at: ... By fax + Fill out the Fair Hearing Request Form. Fax the form to the Office of Medicaid, Board of Hearings at (617) 847-1204. Online + Updates to this are in process,

What is MassHealth timely filing limit?

Initial claims must be received by MassHealth within 90 days of the service date. If you had to bill another insurance carrier before billing MassHealth, you have 90 days from the date of the explanation of benefits (EOB) of the primary insurer to submit your claim.

What is the filing limit for MassHealth?

Initial claims must be received by MassHealth within 90 days of the service date. If you had to bill another insurance carrier before billing MassHealth, you have 90 days from the date of the explanation of benefits (EOB) of the primary insurer to submit your claim.

Does MassHealth back pay?

Federal and state Medicaid law requires MassHealth to recover assets from the estates of certain MassHealth members after their death. This process is called \u201cestate recovery.\u201d The assets are used to reimburse (pay back) the state for the cost of care that MassHealth paid for the member.

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How do I file a 90 day waiver for MassHealth?

90-day waiver requests must be submitted electronically via the Provider Online Service Center (POSC) direct data entry (DDE) using the attachments tab and the appropriate HIPAA delay reason code(s). Each individual 90-day waiver claim must be submitted with supporting documentation that is relevant to that claim.

What time does MassHealth customer service open?

Call the MassHealth Customer Service Center at 800-841-2900 (TDD/TTY: 711). Hours: Monday- Friday, 8 a.m. to 5 p.m.

Does MassHealth back pay?

Federal and state Medicaid law requires MassHealth to recover assets from the estates of certain MassHealth members after their death. This process is called \u201cestate recovery.\u201d The assets are used to reimburse (pay back) the state for the cost of care that MassHealth paid for the member.

How do I submit a MassHealth claim?

By phone + Call the MassHealth Customer Service Center: Main: (800) 841-2900. TTY: (800) 497-4648.

What is the filing limit for MassHealth?

Initial claims must be received by MassHealth within 90 days of the service date. If you had to bill another insurance carrier before billing MassHealth, you have 90 days from the date of the explanation of benefits (EOB) of the primary insurer to submit your claim.

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