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MassHealth Provider Online Service Center
Provider Enrollment Application
Modify Service Locations
The Service Locations panel allows
the applicant/provider to maintain the provider?s service location, doing
business as name and address information. The user selects a service location
name from the List of Locations panel and then can add, delete or update the
service location data from the Location Detail panel and if applicable, the
Nursing Home Detail panel.
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Fields marked with a red asterisk (*) are required.
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Dates must be in mm/dd/ccyy
format. Clicking on the calendar box creates a popup calendar to aid in date
selection and entry.
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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.
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Click
 to close this Help panel.
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Step
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Action
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Response
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1
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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.
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a) A Location 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.
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2
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Directions for entering any of the values on the List Of
Locations panel follow:
Type Values
Type values in the
DBA Name,
Contact,
DBA Address,
Address Line 2 and
City fields.
Drop Down List Box
Select a value from the drop down list box for the DBA State
fields.
Type Values
Type values in the
DBA Zip Code,
Email,
Phone Number and
Fax Number fields.
Radio Buttons
Select an available option, values, etc by clicking on a
radio button for the TDD/TTY field (possible values are Yes
and No).
Type Values
Type values in the Phone Number field.
Radio Buttons
Select an available option, values, etc by clicking on a
radio button for the Please indicate if you currently use the services of
a billing intermediary when submitting claims to MassHealth? field
(possible values are Yes and No).
**** Nursing Home Detail - If the provider is a nursing
home
Type Values
Type values in the Medical Director Name, Administrator Name, and
Administrator License # fields.
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Perform Steps 3, 4
and 5 to Cancel Item, Update or Remove on the Location Detail Panel.
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3
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To back out any changes
on this panel that have not been
saved yet, click on Cancel Item on the Location Detail panel.
OR
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Any unsaved modifications to the Location Detail panel are
removed and the panel closes.
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4
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Click on Update on the Location Detail panel.
OR
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The record is updated and the Location Detail panel
closes.
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5
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Click on Remove on
the Location Detail panel.
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The record is deleted and the Location Detail panel
closes.
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Perform Steps 6, 7,
8 and 9 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.
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6
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Click on Back on the List of Locations panel.
OR
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The system navigates to the previous panel in the provider
enrollment process and displays the Legal Entity Detail panel.
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7
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Click on Continue on the List Of Locations panel.
OR
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The system continues the provider enrollment process and
displays the Address Type ? List of Locations panel.
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8
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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
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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.
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9
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Click on Save on the List of Locations panel.
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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.
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MassHealth Provider
Online Service Center
Provider Enrollment
Application
Add Service Location
The Service Locations panel allows
the applicant/provider to enter the provider?s service location, doing
business as name and address information. The user selects the New Item Button
and then can add the service location data, and if applicable, the Nursing
Home 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.
|
|
Step
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Action
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Response
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1
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Click on New Item on the List of Locations panel.
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A Location Detail panel appears with pre-filled or blank
values in each field.
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2
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Directions for entering any of the values on the Location
Detail panel follow:
Type Values
Type values in the
DBA Name,
Contact,
DBA Address,
Address Line 2 and
City fields.
Drop Down List Box
Select a value from the drop down list box for the DBA State
fields.
Type Values
Type values in the
DBA Zip Code,
Email,
Phone Number and
Fax Number fields.
Radio Buttons
Select an available option, values, etc by clicking on a
radio button for the TDD/TTY field (possible values are Yes
and No).
Type Values
Type values in the Phone Number field.
Radio Buttons
Select an available option, values, etc by clicking on a
radio button for the Please indicate if you currently use the services of
a billing intermediary when submitting claims to MassHealth? field
(possible values are Yes and No).
**** Nursing Home Detail - If the provider is a nursing
home
Type Values
Type values in the Medical Director Name, Administrator Name and
Administrator License # fields.
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Perform Steps 3 and
4 to Cancel Item or Add on the Location Detail panel.
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3
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To back out any changes
on this panel that have not been
saved yet, click on Cancel Item on the Location Detail panel.
OR
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Any unsaved modifications to the Location Detail panel are
removed and the panel closes.
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4
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Click on Add on
the Location Detail panel.
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The record is added and the Location Detail panel closes.
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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.
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5
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Click on Back on the List of Locations panel.
OR
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The system navigates to the previous panel in the provider
enrollment process and displays the Legal Entity Detail panel.
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6
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Click on Continue on the List of Locations panel.
OR
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The system continues the provider enrollment process and
displays the Address Type ? List of Locations panel.
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7
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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
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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.
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8
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Click on Save on the List Of Locations panel.
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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.
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