masshealth staff directory

MassHealth corporate office is located in PO Box 2906, Milwaukee, Wisconsin, 53201, United States and has 1 employees. Saturdays in February: Urgent Care Walk-In Hours. Those residing in a memory care community may be eligible for the Group Adult Foster Care waiver and SSI-G. . Meet the Leadership. This is a consumer-directed program, which provides personal care services for people with disabilities. 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. ) or https:// means youve safely connected to the official website. 7130 0 obj <>stream Thank you. Providers are notified by MassHealth when it is time to complete their revalidations. Working with its network of providers, MBHP offers high quality, accessible, culturally sensitive health care to Members of the MassHealth Primary Care Clinician (PCC) Plan, Community Care Cooperative (C3), Mass General Brigham ACO, Steward Health Choice . 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 Our mission is to ensure that MassHealth members understand their healthcare rights and health plan benefits so they can get the care they need. H|W7&v0$ ( `U}/j}T!_Y1f?Qf2epkxZ [. learn more. PCC Information. The first link below will take you to the MassHealth Provider Directory to find a primary care clinician(PCC), specialist, or hospital. TTY: (800) 497-4648. Our program serves MassHealth members of all ages, abilities, and identities who are currently enrolled in MassHealth health plans, including those found here. MassHealth providers in Massachusetts listed on Doctor.com have been practicing for an average of: Average ProfilePoints score for Providers in Massachusetts who take MassHealth: Average Overall User Rating for Providers in Massachusetts who take MassHealth. 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. Providers can notify MassHealth and submit a request to update their provider file through the POSC (non-LTSS providers) and though the LTSS Provider Portal (LTSS providers). April Bridges-Poquis, DDS is an Orthodontist in Midlothian, VA. . Mass Senior Care Association Offers Resources and Support to Help You Protect Your Long Term Care Community. MBHP verifies the Organizational Provider's accreditation during the initial credentialing process and every three years during the re-credentialing process. The information listed in theMassHealth Network Provider Directory is based on MassHealth Provider file information. 227 verified reviews. This information is self-reported by the practitioner and primary source verified during the initial credentialing application process and at least every 36 days thereafter during the recredentialing application process. Providers must notify MassHealth of any changes in their information. Average Overall User Rating for Providers in Massachusetts who take MassHealth: 5 (out of 5) A lock icon ( Apply for MassHealth, the Health Safety Net, or the Children's Medical Security Plan. A lock icon ( This provider is a medical doctor whose internship/residencies were specialized in the treatment of mental disorders. As of 2022 (per the MassHealth website) the non-refundable application fee is $631 to even apply to be a provider. If you email us or leave us a voicemail, a Community Liaison will reply within 24 business hours. Charlestown, MA 02129-0214. Providers have 45 days from the date of the revalidation letter to complete the revalidation process. Under the leadership of Executive Director David Seltz, the HPC staff is divided into six departments. A .mass.gov website belongs to an official government organization in Massachusetts. Apply to Benefits Manager, Chief Information Officer, Director of Care and more! We listen to you with compassion and respect. 13841 Hull Street Rd, 4, Midlothian, VA 23112. of the information submitted in the application. athol dental assoc. You can read about the doctor's biographical information, clinical interests and past research, as well as see photos and videos. Please do not include personal or contact information. Online Speak to a Licensed Agent. Behavior Management Monitor (BMM) 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. This page is located more than 3 levels deep within a topic. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. 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. My Ombudsman is committed to promoting health . They are qualified to prescribe medication as a means to alleviate symptoms. Start here to learn if you are covered by MBHP, what we offer, and answers to frequently asked questions. Top-requested sites to log in to services provided by the state. 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. They are credentialed by the American Nurses Credentialing Center (ANCC) in a mental health field. Open Enrollment for Individuals and Families is Now Closed Enroll in coverage any time of the year if you are applying for dental plans or help paying for health coverage including MassHealth, Children's Medical Security Plan (CMSP), Some page levels are currently hidden. Dental providers and businesses will be notified by DentaQuest when it is time to recredential. MassHealth Info and Other Important Contacts, 1000 Washington Street, Suite 310 | Boston, MA 02118-5002 | 1-800-495-0086 | Website questions, comments, or feedback: [email protected], Privacy Policy | Terms and Conditions | Download Acrobat Reader You skipped the table of contents section. We use cookies and limited processing of your personal information for our . Use this button to show and access all levels. Intensive Care Coordination (ICC) A lock icon ( 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. Employee Self Service provides you with anytime access to payroll and benefits information. If you need assistance, please contact the Massachusetts Health Policy Commission. To speak with one directly, in English . Nancy Ryan, JD Providers have 45 days from the date of the revalidation . Services offered range from detox, to crisis counseling, to long-term therapy. Failure to do so constitutes a breach of the provider contract. Use this button to show and access all levels. DirectorResearch and Cost Trends Some page levels are currently hidden. See Section 6401 of the Affordable Care Act, 42 CFR 455.414 and 42 CFR 455.104 (c) (l) (iii). This is a part of the MassHealth Provider Handbook. Names of Office and Executive Staff Title Address; Executive Office of Health and Human Services (617) 573-1600: Kate Walsh: Secretary: One Ashburton Place 11th Floor Boston, MA 02108: . Suggestions are presented as an open option list only when they are available. Does not cover other MassHealth Standard services. The . Box 290794. We will use this information to improve this page. ;[z[usd){^K1N ;gaWMm[C)t:R?bl::6I|S ifWlys,$zN\kffjJ(]Y&#Kg\{$rbF1_F%FT%6iHhTOhV[EqF6xEy6a 9B2(N9nSQ Jjp}Q f1rBQ|,om>ol06dtkz2,G3{f?gf1YnQc\^Q,U}&"Jtr@L{{3xlVC{ @;RAo p7p[1s#>qQ&DJ74"S, KV XF7F78Px) iQT76|RT46PuZ7mh@!qF3g[0BttS:1 )l0TT7B0-B)sA&7!R2 S > |ctHL\F9RDj7k lU$lS3WM/ This information is self-reported and verified during the initial credentialing process and every three years or more often when requested by the provider. Dental providers and businesses will be required to complete a recredentialing application utilizing App Central. You can reach us by phone or email. A great management team here to support you and an abundance. An official website of the Commonwealth of Massachusetts, This page, Health and Human Services Contact Information, is, Call Executive Office of Health and Human Services at. 1-800-495-0086 Need language assistance? 11. Marlborough, MA 01752. 0@ > Thank you for your website feedback! Leave a message on our secure voicemail system at any time. Network providers are recredentialed every 5 years. MBHP manages behavioral health care for the BeHealthy Partnership, an Accountable Care Organization, serving Western Massachusetts. Some physicians are employed by affiliates Saint Vincent Hospital . Other services available Monday-Friday 8 a.m.5 p.m. Interpreter service available. Mass PCA Directory Provider Revalidation. We also serve children in state custody and others. We are wheelchair accessible. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Call us Toll Free Massachusetts Medicare Insurance . Share sensitive information only on official, secure websites. Under the leadership of Executive Director David Seltz, the HPC staff is divided into six departments. Deputy Executive Director and Chief of Staff, Office of the General Counsel The LTSS Provider Portal is a web-based portal that is available to MassHealth LTSS providers. The MBHP directory lists behavioral health providers (mental health and addiction). hmKA/O H-/x.KZm9I Please let us know how we can improve this page. MassHealth has an online directory that lists demographic information for Behavioral Health providers, specialists, andproviders in the Primary Care Clinician Plan and Primary Care Accountable Care Organizations. See the 2023 health plan comparison chart on page 5 of the Faculty/Staff Benefits Guide for an overview of the plan options. Provide clinical leadership and mentoring for the OCA and MassHealth staff and work collaboratively with both clinical and non-clinical team members. Agents connected with this website are not endorsed or associated with the US government or federal health program and have not been validated by this website.MassHealth.com is a purely information based site intended to connect residents of Massachusetts with companies and insurance agents in Massachusetts. Speak with a Patient Coordinator on the Phone. Please limit your input to 500 characters. 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 . 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. Please limit your input to 500 characters. Providers are notified by MassHealth when it is time to complete their revalidations. Scuba Certification; Private Scuba Lessons; Scuba Refresher for Certified Divers; Try Scuba Diving; Enriched Air Diver (Nitrox) Advanced Training. 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 . It also provides information on openings Emergency Services Programs, inpatient programs, and other 24-hour services. We are currently NOT accepting Medicaid plans. Phone contact and consultation are provided as part of the intervention. website and services to function. Below outlines the LTSS Provider Portal functionalities: The feedback will only be used for improving the website. MassHealth will select providers each month for revalidation based on their date of enrollment. They often work with or supervise mental health professionals who will provide the counseling in conjunction with the prescribed medication. Though our office is currently closed due to COVID-19, all other My Ombudsman services remain available. This PID/ SL is 10 characters, made up of a 9-digit base, in their information. Living in community, eligible for Medicare >100% and <135% FPL $7,560 Assets MassHealth Buy-In Covers Part B premiums only. Go to eServe. revalidation based on their date of enrollment. They include Advanced Practice Registered Nurses (APRN). Other information such as Federally Required Disclosures Form (FDRF) may be required. Quality Management Program. 65.5 mi. Provide clinical leadership and mentoring for the OCA and MassHealth staff and work collaboratively with both clinical and non-clinical team members. Heres what you need to know about how to get around >, MassHealth Managed Care Entity Bulletin 76. masshealth dental services. Suggestions are presented as an open option list only when they are available. Support and participate in our professional . Some page levels are currently hidden. The feedback will only be used for improving the website. MassHealth providers in Massachusetts listed on Doctor.com have been practicing for an average of: 22.8 year (s) Average ProfilePoints score for Providers in Massachusetts who take MassHealth: 62/80. Please do not include personal or contact information. This PID/ SL is 10 characters, made up of a 9-digit base number and an alpha service location letter (e.g., 123456789A). Worcester Community Health Centers/Training Centers Staff Dentist Family Health & Social Worcester, MA 01610 26 Queen St MassHealth, the Medicaid program in Massachusetts offered by the Commonwealth of Massachusetts, does not finance assisted living. more, MBHP network providers can view the Provider Manual and performance specifications, submit claims, request service authorizations, and much more. 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. MassHealth has prepared a variety of job aids as part of the POSC e-Learning courses. 1(855) 264-3156. Mass General Brigham MassHealth ACO is a health plan for MassHealth members offered by Mass General Brigham. 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. 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. by providers with Doctor.com accounts when editing their profile on Doctor.com. 4.85. Apply for MassHealth coverage for seniors and people of any age who need long-term-care services. Looking for a therapist? Heres what you need to know about how to get around >, MBHP is here to provide you or your loved one with a full range of services to help with medical, mental health, and substance use disorder conditions. Phone: 1-800-MEDICARE (800) 633-4227. By choosing "OP Clinic/MH Center," you will include the following provider types in your search: Outpatient Clinics and Mental Health Centers. ) or https:// means youve safely connected to the official website. Dentist. Wondering if you are covered by MBHP? Outpatient Clinic/Mental Health Center: Through our PCA Program, Tempus Unlimited serves over 7,000 individuals living in Massachusetts . 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. This information is self-reported and verified during the initial credentialing process and every three years or more often on the provider's credentialing application, which is a signed document in which the provider confirms the information is accurate and complete. 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. We're currently processing your request and we'll be in touch soon. While My Ombudsman cannot represent a member when they file a grievance or appeal, we can explain the process and what to expect. 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. Our office is located in Boston at 25 Kingston Street 4th Floor. Please let us know how we can improve this page. The provider's special field of practice or expertise, which is obtained through the provider's credentialing application. MassHealth Members who are or are trying to become VG users: 1-800-421-0938 (Voice) 1-617-847-6578 (TTY for the deaf and hard of hearing) Call the MassHealth Customer Service Center at 800-841-2900 or 800-497-4648 (TTY) to request a Medical Benefit Request (MBR). Specific types of providers in this category are: Psychologist (EdD); Psychologist (PsyD); and Psychologist (PhD) (can be a specialist called a Neuropsychologist). We also have a phone interpretation service available for over 150 languages. Sanctions may include, but are not limited to, administrative fines and suspension or termination from participation in MassHealth. Call toll-free (866) 494-3627 Use the referral request form. Behavior Management Therapist (BMT) As part of the required revalidation process, MassHealth must revalidate the enrollment information of all enrolled providers and site locations. If you need assistance, please contact the Executive Office of Health and Human Services. Each department works on focused areas as well as collaborative, intra-agency projects to ensure that the HPCs statutory deadlines are met in a robust, transparent, and timely manner. We may offer benefits directly or help pay for all or part of your health insurance premiums. The paraprofessional assists the clinician in implementing the therapeutic objectives of the treatment plan designed to address the youth's mental health, behavioral, and emotional needs. Nurse Practitioner (Dermatology) 3809 Computer Dr, Ste 200, Raleigh, NC 27609. 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. See Section 6401 of the Affordable Care Act, 42 CFR455.414 and 42 CFR 455.104(c) (l) (iii). Each department works on focused areas as well as collaborative, intra-agency projects to ensure that the HPC's statutory deadlines are met in a robust, transparent, and timely manner. Per 130 CMS 450.223(B), all providers are required to notify MassHealth of any change in any of the information submitted in the application. MassHealth Senior Buy-In Covers Medicare premiums, co-pays, and deductibles. Suggestions are presented as an open option list only when they are available. ) or https:// means youve safely connected to the official website. Providers, business partners, and relationship entities must be enrolled in and/or registered to use the POSC. Management of profile information. 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. 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. Transformation and . Suggestions are presented as an open option list only when they are available. Use this button to show and access all levels. This page is located more than 3 levels deep within a topic. MassHealth, the Commonwealth's Medicaid program, provides health care benefits to certain low and medium-income Massachusetts residents. https://application.abpn.com/verifycert/verifycert.asp, https://www.certificationmatters.org/find-my-doctor/, https://certification.osteopathic.org/bureau-of-osteopathic-specialists/, https://www.nursingworld.org/certification/verification/, https://www.bacb.com/verify-certification. 58.5 mi. We will use this information to improve this page. Any MassHealth health plan member can reach out to My Ombudsman when they have questions about their health plan benefits, when they have been denied a benefit or a service, or when they need help understanding their rights. 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. Advanced Scuba Diver; Ultimate Rescue Diver; Specialties. This directory lists physicians on Saint Vincent Hospital medical staff who choose to participate. Failure to do so constitutes a breach of the provider contract which may be subject, to fines or termination. Failure to complete revalidation in a timely fashion will result in sanctions. 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 changes are significant (i.e., change of business address or change of ownership) and may require a new application to be submitted. Once licensed, in most states, they can supervise other counseling providers not yet licensed.