Help

MassHealth Provider Online Service Center

Provider Enrollment Application

Add/Modify Personal Info - Service Location

The Personal Info panel allows the applicant/provider to enter, view, and maintain servicing information pertaining to a service location, such as number of members, payment method, language, office hours, number of beds, if applicable etc. The user selects a service location from the List of Locations panel and then can add or update the service location data from the Personal Detail panel.

• Fields marked with a red asterisk (*) are required.

• Dates must be in mm/dd/ccyy format. Clicking on the calendar box creates a popup calendar to aid in date selection and entry.

• Error Resolution:

If an error is detected a statement is displayed in the upper portion of the panel. The statement indicates the problem and the method of correction and is preceded by a small red circle with a white "x" () in it. The small red circle with a white "x" () also appears next to required fields that are in error.

• Click to close this Help panel.

1

a) Click on a Location Record to be modified from the List of Locations panel.

OR

b) Use the numbers and arrows to Scroll through for more record choices.

a) A Personal Detail panel is filled with all the values for the selected record.

b) Additional lists of records for the List of Locations panel are displayed.

2

Directions for entering any of the values on the Personal Detail panel follow:

Protected Field

The panel is displayed with the Service Location field already stored by the system and protected from modification.

(Radio Buttons

Select an available option, values, etc by clicking on a radio button for the Are you accepting new members? field (possible values are Yes and No).

And if Yes entered then

Type Values

Type values in the Enter the maximum no. of members requested field. )

Drop Down List Box

Select a value from the drop down list box for the Preferred method of communication and

Preferred method of payment fields.

Type Values

Type values in the Age Less Than and Age Greater Than fields.

Radio Buttons

Select an available option, values, etc by clicking on a radio button for the Handicap Access field (possible values are Yes and No).

Assign Available Codes

1) Select values for the Selected Language capabilities field:

2) A text box of all available values appears on the left side of the panel with a text box of assigned values on the right. A column of arrows is in between the two text boxes.

3) Clicking on the right single arrow (>) sends one value at a time from the available list to the assigned. Clicking on the left single arrow (<) sends one value at a time back from the assigned list to the available list.

4) Clicking on the right double arrow (>>) sends all the values from the available list to the assigned list. Clicking on the left double arrow (<<) sends all the values back from the assigned list to the available list.

( Type Values

Type values in the Monday Opening Time, Monday Closing Time, through Sunday Opening Time, and Sunday Closing Time fields.

and

Drop Down List Box

Select a value from the drop down list box for the AM/PM fields. ).

If the provider is a nursing home then:

Type Values

Type values in the Number of Certified Beds, Total Licensed Beds, and Number of Medicaid Beds fields.

Perform Steps 3 and 4 to Cancel Item or Update on the Personal Detail Panel.

3

To back out any changes on this panel that have not been saved yet, click on Cancel Item on the Personal Detail panel.

OR

Any unsaved modifications to the Personal Detail panel are removed and the panel closes.

4

Click on Update on the Personal Detail panel.

The record is updated and the Personal Detail panel closes.

Perform Steps 5, 6, 7 and 8 to go Back to the previous panel, Continue to the next panel, Cancel, or Save on any unsaved data on any panels accessed during this process.

5

Click on Back on the List of Locations panel.

OR

The system navigates to the previous panel in the provider enrollment process and displays the Medicare Info panel.

6

Click on Continue on the List of Locations panel.

OR

The system continues the provider enrollment process and displays the Specialty Info panel.

7

To back out any changes on any panels that have not been saved yet, click on Cancel Service on the List of Locations panel.

OR

Any unsaved modifications or deletes to any panels during this process are backed out and the system returns to the initial Start An Enrollment Application - Security Warning panel.

8

Click on Save on the List of Locations panel.

All information input on any panel for the provider enrollment application is saved. This allows the user to save the data and, exit the provider enrollment application process, and continue the provider enrollment application at another time. The system displays an Application Saved panel.