Calling MassHealth

Here are a few more pieces of contact information from Health Law Advocates' flyer about MassHealth dental changes (PDF):

DORAL DENTAL (which now operates the MassHealth dental program):

• You need a release form to speak to them: There are two kinds of release forms and you can use either to speak to MassHealth/Doral on a member’s behalf: the standard MassHealth Permission to Share Information (PSI) form and the Doral Personal Health Information (PHI) Form.
• Fax PSI/PHI to "attention Marjorie G." at 1-262-834-3450. Doral will not give you any information WITHOUT this release on file.
• To find a provider, search claims history or check on a prior authorization call: Doral Dental Customer Service: (800) 207-5019.
• For appeals or if Customer Service is not helpful:
  DORAL DENTAL INTERVENTION SERVICES: Pearl Panico (617-886-1725) and Deborah Solares (617-886-1726)

Dr. Timothy Martinez is the DENTAL DIRECTOR at MassHealth. Dr. Martinez can troubleshoot for both providers and advocates with prior authorizations and claims.

• To contact: Timothy.S.Martinez@state.ma.us

Here are a few more phone numbers that Anne Rosen passed on from the April '08 MTF --

• MassHealth Third Party Liability Unit: 1-888-628-7526 (fax: 617-357-7604)
• Medicare/Senior Plan Updates: 1-800-628-1120 option 3 (fax: 617-886-8133)
• Hospice Service Updates: 1-800-426-1120 option 3 (fax: 617-886-8133)
• Health Safety Net Helpdesk: 1-877-910-2100

This isn't regarding contact information, but I think that it is important for applicants to know that asset recovery does not apply to the Commonwealth Care program. We have had a few callers that are hesitant to sign the MBR due to the section about estate recovery. Hopefully we can get this language changed, so that it is clear that asset recovery does not apply to Commonwealth Care members.

So far the most usual bit of information for out clients is for those attempting to overnight mail a payment in for Commonwealth Care. I think we may have been given this address at one of several meetings we were attending this summer but just in case here you are.

Commonwealth Care
365 West Passaic Street
5th floor
Rochelle Park NJ 07662

The systems we interface with, and the regulations related to the programs they manage, are increasingly complex. There are many instances of "right hand, left hand" confusion. Despite years of experience working with these programs it is not always obvious where to turn for information about specific issues related to application, approval, enrollment, premium billing, etc. It seems like now more than ever, a central clearinghouse for enrollment specialists is needed to reduce the inefficiencies and lack of coordination in these systems. Our clients are often surprised that we have to go through the same process (including delays, and getting cut off) as all other callers when contacting the state. It would benefit everyone -- those of us who work with the systems and our clients -- if there were a central contact point for ALL inquiries that can't be resolved via checking MAPS &/or REVS -- a sort of case management system for enrollment staff.