FAQ Related to MassHealth Insurance
Perhaps, you have lots of questions in regards to MassHealth Insurance of Massachusetts. If so, then you should go through these FAQ which will provide you with ample knowledge about the topic.
FAQ on MassHealth Insurance of Massachusetts Prior Authorization
Q. MassHealth Prior Authorization – What is it?
A. It enables MassHealth to evaluate, review, modify, deny and approve chosen non-emergency medical services before payment for services such as adult foster care.
Q. What is the application process?
A. Essential paperwork will be sent by your doctor documenting your needs or illness. All necessary application forms for MassHealth Authorization are compiled to provide coverage.
Q. Does MassHealth offers automatic approvals?
A. MassHealth will either modify, deny or approve your request on a case by case basis.
Q. How much time does it take to get a response from MassHealth?
A. Generally decisions are offered by MassHealth within 2-3 weeks.
Q. What happens after approval by MassHealth?
A. You will be received an approval letter in the mail to your listed address.
Q. What happens if there is any modifications to need to be addressed?
A. You will be contacted by MassHealth directly.
Q. What happens if you get denied?
A. You will be notified about the decision promptly. At times, denials could be due to incomplete paperwork. In such a case, your caregiver and/or provider will be contacted upon to provide essential forms. Instructions are provided in your Decision Notice to appeal for a denial.
Q. For what duration is my authorization valid for?
A. MassHealth provides Expiration Date on Decision Notice. 1 year is the maximum time permitted for prior authorization approvals.
Q. Will there be automatic renewal of my authorization?
A. On expiration of your authorization, new authorization request needs to be submitted. This process should be started prior to current authorization getting expired. This will help to ensure submission of all essential paperwork and also to avoid lapse in services.
Q. What if my status changes while my application is pending?
A. In the case that you do not qualify for Mass Health due to a change in your status, you will not be able services, although given Prior Authorization has not expired.
For questions pertaining to Mass Health eligibility, call MassHealth at 800-841-2900.