masshealth staff directory masshealth staff directory

MassHealth providers need to revalidate their information at least every five years. Top-requested sites to log in to services provided by the state. Call the MassHealth Customer Service Center at 800-841-2900 or 800-497-4648 (TTY) to request a Medical Benefit Request (MBR). Mass.gov is a registered service mark of the Commonwealth of Massachusetts. April Bridges-Poquis, DDS is an Orthodontist in Midlothian, VA. . It includes over 1,200 clinics, inpatient programs, individual practitioners such as social workers and psychologists, and many more. Meet the Leadership. General Counsel, Health Care Transformation and Innovation MBHP understands that safe and stable housing is the foundation upon which good health is built. Failure to complete revalidation in a timely fashion will result in sanctions. Thank you for your website feedback! Long term care facilities practice quality infection control procedures every day however, the coronavirus (COVID-19) has heightened the focus on infection prevention and control. My Ombudsman staff come from culturally and linguistically diverse communities and have experience in areas such as advocacy, social services, and healthcare, to name a few. more, MBHP network providers can view the Provider Manual and performance specifications, submit claims, request service authorizations, and much more. Family Support and Training is a service provided to the parent/caregiver of a youth (under the age of 21), in any setting where the youth resides, such as the home (including foster homes and therapeutic foster homes), and other community settings. We may offer benefits directly or help pay for all or part of your health insurance premiums. Charlestown, MA 02129-0214. Information about the HPC's leadership team. Fee-For-Service (FFS) and MassHealth Provider Network, Primary Care Clinician Plan & Primary Care Accountable Care Organizations, Managed Care Organizations and Accountable Care Partnership Plans, MassHealth Electronic Data Interchange (EDI), MassHealth Coordination of Benefits (COB)/Medicare Crossover, MassHealth Claim Status, Reconciliation, and Additional Claims Resources. Phone contact and consultation are provided as part of the intervention. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. H|W7&v0$ ( `U}/j}T!_Y1f?Qf2epkxZ [. Participate/lead in the development of oral health policies, clinical standards, evidence-based clinical guidelines, criteria, and algorithms for use in MassHealth, ensuring adherence to all . Please let us know how we can improve this page. Specific types of providers in this category are: Psychologist (EdD); Psychologist (PsyD); and Psychologist (PhD) (can be a specialist called a Neuropsychologist). Getting Started. We also have a phone interpretation service available for over 150 languages. My Ombudsman staff come from culturally and linguistically diverse communities and have experience in areas such as advocacy, social services, and healthcare, to name a few. We are passionate about using our skills, expertise, and personal experience to help members get the care they need. Resources. MassHealth, the Commonwealth's Medicaid program, provides health care benefits to certain low and medium-income Massachusetts residents. MassHealth has an online directory that lists demographic information for Behavioral Health providers, specialists, and, providers in the Primary Care Clinician Plan and Primary Care Accountable, on MassHealth Provider file information. Dental providers and businesses will be notified by DentaQuest when it is time to recredential. See the 2023 rates for payroll contribution based on your coverage level. How to find Find a PCC Plan provider. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. MassHealth Info and Other Important Contacts. Providers are notified by MassHealth when it is time to complete their revalidations. %PDF-1.7 % For this type of provider, most states require a doctorate degree from the psychology department of an accredited college and that the provider has passed a national licensing exam. The staff at MassHealth is dedicated to ensuring people who apply for coverage and shop for insurance plans on our website have the best experience possible. dm{&CIQ2U]t]fk-={b6xn`93}XDh\9":<89oJc*"w;= .J The provider will be only listed in a requested specialty that the Massachusetts Behavioral Health Partnership can verify and that the provider has the education and training to support the requested specialty. My Ombudsman is an independent program operated by the Disability Policy Consortium (DPC) through a contract with MassHealth. See the regulations at 130 CMR 450.222 and 130 CMR 450.223(B): Some of the ways that providers can report their changes to MassHealth: For more information regarding provider enrollment and credentialing, including change of provider address information, please go to the MassHealth Provider Enrollment and Credentialing (PEC)web page. Feeling shy? ) or https:// means youve safely connected to the official website. Our mission is to ensure that MassHealth members understand their healthcare rights and health plan benefits so they can get the care they need. website and services to function. See Section 6401 of the Affordable Care Act, 42 CFR455.414 and 42 CFR 455.104(c) (l) (iii). Please limit your input to 500 characters. A lock icon ( You skipped the table of contents section. If you are experiencing a mental health or substance use disorder crisis, the Community Behavioral Health Centers (CBHCs)/Mobile Crisis Intervention (MCI) is available 24 hours a day, 7 days a week, 365 days a year. manages behavioral health care for more than 500,000 MassHealth Members statewide. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. National Accreditation demonstrates the exceptional quality of the contracted/credentialed Organizational Provider (Facility). My Ombudsman is committed to promoting health . Suggestions are presented as an open option list only when they are available. Behavior Management Monitor (BMM) A .mass.gov website belongs to an official government organization in Massachusetts. Then, we provide support, which could include answering questions, helping to identify barriers or address confusion, investigating complaints, mediating between parties, explaining member rights, and making referrals. ) or https:// means youve safely connected to the official website. We also serve children in state custody and others. Sanctions may include, but are not limited to, administrative fines and suspension or termination from participation in MassHealth. People who meet a spend-down deductible may also qualify for MassHealth Standard. Dental providers and businesses will be required to complete a, Questions related to recredentialing can be, Provider Enrollment and Credentialing team at. We have compiled a list of resources for our Members who may be experiencing homelessness, housing instability, and/or housing discrimination. See Section 6401 of the Affordable Care Act, 42 CFR 455.414 and 42 CFR 455.104 (c) (l) (iii). Provide clinical leadership and mentoring for the OCA and MassHealth staff and work collaboratively with both clinical and non-clinical team members. To speak with one directly, in English . A full breakdown of points can be seen MassHealth. Quality Management Program. Were glad youre here. This service includes teaching the youth to understand, direct, interpret, manage, and control feelings and emotional responses to situations and to assist the family to address the youth's emotional and mental health needs. Suggestions are presented as an open option list only when they are available. We will use this information to improve this page. The practitioner provides services which includes implementing the behavior treatment plan, monitoring the youth's behavior, reinforcing implementation of the treatment plan by the parent(s)/guardian(s)/caregiver(s), and reporting to the behavior management therapist on implementation of the treatment plan and progress toward behavioral objectives of performance goals. Please remove any contact information or personal data from your feedback. For help on some common issues, see here. The Commissioner's Office includes offices that coordinate cross-cutting data, policy, and programmatic issues, providing support throughout the bureaus. Insurance info unavailable. We stay neutral we do not judge, we do not decide who is right or wrong, and we do not represent members or insurance plans. The Mass General Brigham MassHealth ACO offers the . MassHealth Behavioral Health Urgent Care Program, Providers who would like to participate in the MassHealth Behavioral Health Urgent Care Program, as described in. with MassHealth online. The Dental Director is a representative of and spokesperson for the MassHealth dental program, participates on various committees, and provides outreach to dentists in the Commonwealth. The first link below will take you to the MassHealth Provider Directory to find a primary care clinician(PCC), specialist, or hospital. Call us Toll Free Massachusetts Medicare Insurance . If you need assistance, please For help on some common issues, see here.. Looking for a great leader to Join our Medicaid Managed Information System (MMIS) Team. By using our services you are able to compare plans and rates from leading insurers quickly and efficiently so you can be confident in the insurance policy you choose. Click on the teams below to learn more about their function within the agency. Coleen Elstermeyer, MPP By calling the phone number listed on this website, completing any form on this page, or clicking on any of the suggested MassHealth providers, you are agreeing to be transferred to a licensed insurance agent who can answer your questions regarding Massachusetts Health Insurance. For the month of February, we will offer walk-in adult urgent care services each Saturday for all UMass Memorial Medical Center primary care patients from 9 am to 12:30 pm on a first come, first served basis. | Download Word Viewer | Download Excel Viewer, For important information about COVID-19, providers click. 58.5 mi. Please do not include personal or contact information. Get the inside scoop on jobs, salaries, top office locations, and CEO insights. We will use this information to improve this page. H|WM]7,BIJ"EehKi?%Y~3d[e}>>>9G ||OxfcO~xw?uOh:q_52p|_ab M0>Y1\Hzjl+by6l\Mr;[fJeA>K8nNg [Mp;\ x8CZ"i:mJq@$Cqqb\:V #8n!]S0=)uAGAbRSv*s^Qg:'LhH{_$NV.I!t*g J~,Twta7u.-gwT(Xz?Kn6rz52adX 'Y2oY(YM(@'w8%d%dh&t!u"Gd 9|y"(lVAnH3IEAj +,4q3&qs,3U? Some page levels are currently hidden. There, Each providers NPI is stored in MassHealths, vider ID and service location (PID/SL). All, users must be enrolled in and/or registered to use, the LTSS Provider Portal. Family Support and Training (FS&T) Employee Self Service provides you with anytime access to payroll and benefits information. Katherine Scarborough Mills, JD, MPH MassHealth has prepared a variety of job aids as part of the POSC e-Learning courses. The jobs, the name of each functional area listed below are, Submitting Residential Care Home/Rest Home, Third Party Liability (TPL) (Note: The Profes, sional and Institutional TPL job aid instructions supplement the instructions found in the Professional and Institutional Claim Submission with, the instructions described in the Professional or Institutional Claim Submission with MassHealth job aids, and then refer to the TPL job aid when, The LTSS Provider Portal is a web-based portal, that is available to MassHealth LTSS providers. learn more. Self-service available 24 hrs/day in English and Spanish. The POSC is a web-based portal that is available to MassHealth providers, business partners, and relationship entities to view information, submit and receive transactions, and effectively conduct business with MassHealth online. The LTSS Provider Portal is a web-based portal that is available to MassHealth LTSS providers. If you email us or leave us a voicemail, a Community Liaison will reply within 24 business hours. The Dental Director leads the MassHealth Dental Advisory Committee, chairs applicable joint committees, and consults with the Center for Health Information and . Phase 4: Analytics vendor transfers all normalization , analytics, and reporting to MassHealth for ongoing operations Including detailed business requirements, technical specifications, and data dictionaries describing all data elements, codes, calculations and algorithms along with training for MassHealth staff . PCC Quick Links. Commissioner's Office Structure. Events and Trainings. Triages inquiries from MassHealth staff and respond in a timely manner. Support and participate in our professional . Our program serves MassHealth members of all ages, abilities, and identities who are currently enrolled in MassHealth health plans, including those found here. Our staff speak Spanish, Portuguese, French, Kreyl, and use American Sign Language. Section 6401 of the Affordable Care Act established a requirement for Medicare and Medicaid to revalidate enrollmentinformation for all enrolled providers, regardless of provider type, under new enrollment screening criteria at least every five years. If you are unable to find your Tufts Health Plan member ID card, please call us at: 800-462-0224 from an accredited college or university. Call Now for the best Insurance Quotes in Massachusetts. TTY: (877)-486-2048. www.medicare.gov. In most states, these nurses are authorized to prescribe psychotropic medications - in some cases independently and others under a formal collaboration agreement or in a supervised setting with a licensed physician. E\NDF"Z8s@C@a`!HomtjGM{pbV"*gDIQCPC** ikI@2$X38UF8CRtg^1~W8C48'YQgh%m8CPUpq6yWx;\ ">=&Up9s;>t(Th`@WgE);9))#1+vA`@(MP*smYD|B%t{h:q2KU,X 3+`q`apcQW`H q I 6K76pwM6[$@7M>wk`tw#\ARce6;">Myi AhqE$8YLe*,PeKm {%qlw%l0%T$hGPe&"`vONVf XVbYu,[`Qd =ZTf2R[=_ CB Please do not include personal or contact information. 13841 Hull Street Rd, 4, Midlothian, VA 23112. David Auerbach, PhD Guided by the needs of our patients and their families, Massachusetts General Hospital aims to deliver the very best health care in a safe, compassionate environment; to advance that care through innovative research and education; and to improve the health and well-being of the diverse communities we serve. MBHP verifies the Organizational Provider's accreditation during the initial credentialing process and every three years during the re-credentialing process. MBHP offers high quality, accessible, culturally sensitive health care to Members of the MassHealth Primary Care Clinician (PCC) Plan, Community Care Cooperative (C3), The MBHP directory lists behavioral health providers (mental health and addiction). An official website of the Commonwealth of Massachusetts, Call MassHealth Customer Service Center, Main: at, Call MassHealth Customer Service Center, TDD/TTY: at. The directory below lists information on 256 assisted living facilities in the state of Massachusetts. MassHealth Senior Buy-In Covers Medicare premiums, co-pays, and deductibles. Contact us if you need help with: Medicare Prescription Drug Coverage. This is a part of the MassHealth Provider Handbook. We are committed to the insurance industry's initiative to give consumers clear information about insurance products and companies.Our revolutionary online tools make it easy for you to get quotes and detailed insurance information with the click of a button and access the most up-to-date insurance rates in the state of Massachusetts. By choosing "OP Clinic/MH Center," you will include the following provider types in your search: Outpatient Clinics and Mental Health Centers. 1-800-495-0086 Need language assistance? Beneath the name of each functional area listed below are links to the job aids associated with processes within those functional areas. 157 Union Street. By showing providers with higher ProfilePoints first, The staff at MassHealth is dedicated to ensuring people who apply for coverage and shop for insurance plans on our website have the best experience possible. 7104 0 obj <> endobj We have a no wrong door approach, so even if the issue is outside the scope of My Ombudsmans expertise, we will try to provide referrals to other organizations that can help. Failure to do so constitutes a breach of the provider contract which may be subjectto fines or termination. Resources. Phone: 1-800-MEDICARE (800) 633-4227. Does not cover other MassHealth Standard services. An ACO is a team of doctors, nurses, and other providers who work together to provide coordinated, high-quality care for members. MassHealth aims to provide competitive quotes in order to produce the best prices and insurance plans for Health Insurance, Life Insurance and Medicare Options in Massachusetts. Contact information for the Executive Office of Health and Human Services. We will never share your information without your permission. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Lois H. Johnson, JD 11. These are practitioners who have received bachelor's or associate's degree in a human services field from an accredited university and have relevant experience working with youth and families who require behavior management to address mental health needs. Please limit your input to 500 characters. The staff can only maintain the medication schedule, remind the residents, and assist in opening bottles . Top-requested sites to log in to services provided by the state. Network providers are recredentialed every 5 years. Some page levels are currently hidden. Dental providers and businesses will be notified by DentaQuest when it is time to recredential. endstream endobj 7105 0 obj <>/Metadata 196 0 R/Pages 7102 0 R/StructTreeRoot 802 0 R/Type/Catalog/ViewerPreferences 7121 0 R>> endobj 7106 0 obj <>/MediaBox[0 0 720 540]/Parent 7102 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 7107 0 obj <>stream Liked by Martha . Examples of changes include corporate/practice structure, change(s) in licensure, closure or opening of new location, change of address, etc. Robert Johnson, NP, DCNP, MSN. Outpatient Clinic/Mental Health Center: Mass PCA Directory Family Support and Training is a service that provides a structured, one-to-one, strength-based relationship between a Family Partner and a parent/caregiver. Enhanced Analytics Strategy 65.5 mi. OR. Kelly Hall We use cookies and limited processing of your personal information for our Dental providers and businesses will be required to complete a recredentialing application utilizing App Central. Some page levels are currently hidden. by providers with Doctor.com accounts when editing their profile on Doctor.com. hmKA/O H-/x.KZm9I All users must be enrolled in and/or registered to use the LTSS Provider Portal. You skipped the table of contents section. Each providers NPI is stored in MassHealths Medicaid Management Information System (MMIS) with a corresponding MassHealth provider ID and service location (PID/SL). Of the six coverage types available, MassHealth Standard applies to low-income state residents aged 65 and older whose medical needs justify long-term care in residential facilities. Hablamos Espaol | Ns falamos Portugus | We use ASL. Manage your favorites on AccessTufts. The Massachusetts Behavioral Health Access website allows medical and behavioral health providers, individuals and families, state agency staff, and others to locate services available through the Childrens Behavioral Health Initiative. This page is located more than 3 levels deep within a topic. A lock icon ( Our office is located in Boston at 25 Kingston Street 4th Floor. Therapeutic Mentor (TM) We also have a phone interpretation service available for over 165 languages. If you are a MassHealth PCC Plan Member, you have access to a large network of primary care providers including physicians, community health centers, and hospitals. Nancy Ryan, JD The jobsaids can be found on the Job aids for the Provider Online Service Center (POSC) webpage. more, MBHP collaborates with primary care clinicians (PCCs) to enhance the integration of medical and behavioral health care, as well as to improve the quality of care offered to PCC Plan Members. Total number of Providers in Massachusetts on Doctor.com who Accept MassHealth: Most popular medical specialty of providers who acceptMassHealth in Massachusetts. If you need assistance, please contact the Executive Office of Health and Human Services. Senior Director, Office of Patient Protection By using our site, you agree to our use of cookies and our. MBHP manages behavioral health care for the BeHealthy Partnership, an Accountable Care Organization, serving Western Massachusetts. Senior Director. Nurse Practitioner (Dermatology) 3809 Computer Dr, Ste 200, Raleigh, NC 27609. We are currently NOT accepting Medicaid plans. Some changes are significant (i.e., change of business address or change of ownership) and may require a new application to be submitted. Providers have 45 days from the date of the revalidation . Office of the Chief of Staff 0 Suggestions are presented as an open option list only when they are available. Speak with a Patient Coordinator on the Phone. Below outlines the LTSS. Mass Senior Care Association Offers Resources and Support to Help You Protect Your Long Term Care Community. These are community-based programs that offer mental health and/or substance use disorder services. As part of the required revalidation process, MassHealth must revalidate the enrollment information of all enrolled providers and site, Providers have 45 days from the date of the revalidation letter to complete the revalidation. Two executive departments have oversight and administrative duties, while four other departments focus primarily on policy, research, and program design/operations. Orthodontist. Dentist. Marlborough Hospital. The Personal Care Attendant (PCA) Program is a MassHealth program that assists people with long-term disabilities live at home independently. Got a Question? The first link below will take you to the MassHealth Provider Directory to find a primary care clinician (PCC), specialist, or hospital. Mass General Brigham ACO, Steward Health Choice, and the BeHealthy Partnership. Provide clinical leadership and mentoring for the OCA and MassHealth staff and work collaboratively with both clinical and non-clinical team members. In order to be board certified, a practitioner must complete certain requirements beyond those required for licensure, including training and experience in the specialty area. The Massachusetts Behavioral Health Partnership (MBHP) manages behavioral health care for more than 500,000 MassHealth Members statewide. Advanced Scuba Diver; Ultimate Rescue Diver; Specialties. If you would like more information regarding Massachusetts health care options please visit http://www.mass.gov/eohhs/insurance. Failure to do so constitutes a breach of the provider contract which may be subject, to fines or termination. Revalidation is completed on the POSC (non-LTSS providers) and the LTSS Provider Portal (LTSS providers). Some changes, are significant (i.e., change of business address or change of ownership) and may require a new, a requirement for Medicare and Medicaid to revalidate enrollment, information for all enrolled providers, regardless of provider type, under new, MassHealth will select providers each month for. Please remove any contact information or personal data from your feedback. MassHealth Info and Other Important Contacts. These providers can offer you check-ups, help with ongoing medical conditions, and more. If you need assistance, please For help on some common issues, see here.. My Ombudsman is committed to promoting health equity by working to ensure all MassHealth members can access the care and services available to them through their plans. No upcoming availability on Zocdoc at this location for the appointment type selected. We value your knowledge and life experience. The provider's special field of practice or expertise, which is obtained through the provider's credentialing application. The feedback will only be used for improving the website. Fee-For-Service (FFS) and MassHealth Provider Network, Primary Care Clinician Plan & Primary Care Accountable Care Organizations, Managed Care Organizations and Accountable Care Partnership Plans, MassHealth Provider Directory, Provider File Maintenance, and Revalidation, MassHealth Electronic Data Interchange (EDI), MassHealth Coordination of Benefits (COB)/Medicare Crossover, MassHealth Claim Status, Reconciliation, and Additional Claims Resources. These offices include: Finance includes Budget, Accounting, Purchase of Services, Facilities, and Internal Controls. Examples of changes include corporate/practice structure, change(s) in licensure, closure or opening of new location, change, Each MassHealth provider must notify the MassHealth agency prior to or no later than the date of the change. Therapeutic Training and Support (TT&S) The provider's special field of practice or expertise, which is obtained through the provider's credentialing application. If you have questions, comments or concerns, please contact us by email, US Postal Service or telephone using the information provided below. Though our office is currently closed due to COVID-19, all other My Ombudsman services remain available. Practitioner must be enrolled into a contract with MassHealth as a billing or non-billingprovider and provide their PID/SL Profession-specific credentialing criteria All network practitioners must meet the general credentialing criteria listed above.