As of July 1, 2011, the state of Massachusetts no longer supplies immunization antigens for adults age 19 and over. Network Health will always reimburse the administration cost and will also reimburse the cost of an antigen when the antigen is a covered benefit for your Network Health patient. The state continues to supply antigens for children under the age of 19.
The January 1, 2012, deadline to upgrade to Version 5010 of the HIPAA transaction standards is fast approaching. These standards cover enrollment, claims, eligibility, remittance, and other electronic transactions. You should schedule testing with us if you have not already done so, or let us know if you are uncertain about when you will be ready to test, by contacting our e-business team by September 30, 2011, at edi@network-health.org or 888-257-1985.
You must submit all new claims within 90 days of the date of service, including claims resulting from an accident where a third party is liable for full or partial payment. The 90-day filing period also applies if you filed your claim in error with another insurer. We will deny claims if we receive them after this 90-day period.
Tamara Pringle is our relations manager serving southeastern Massachusetts. In her ten years in health care — eight at Network Health — Tamara has dedicated herself to exceeding provider expectations and providing the best possible customer service.