Masscollaborative.org

Mass Collaborative

WEBThe Mass Collaborative is a voluntary open organization of more than 35 payers, providers, and trade associations dedicated to reducing complex and cumbersome health care …

Actived: 3 days ago

URL: http://www.masscollaborative.org/

Introducing: Universal Provider Request for Claim Review Form

WEBThe Massachusetts Health Care Administrative Simplification Collaborative*, a multi-stakeholder group committed to reducing health care administrative costs, is proud to …

Category: Health Go Health

PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL ASSESSMENT …

WEBPSYCHOLOGICAL AND NEUROPSYCHOLOGICAL . ASSESSMENT SUPPLEMENTAL FORM. Provide . specific. information in context of each health plan’s unique medical

Category: Medical Go Health

INTRODUCING: UNIVERSAL PROVIDER REQUEST FOR CLAIM …

WEB2 (continued on next page) Massachusetts Collaborative — Introducing: Universal Provider Request for Claim Review Form June 2023

Category: Health Go Health

INTRODUCING: UNIVERSAL PROVIDER REQUEST FOR CLAIM …

WEB7(continued on next page) Massachusetts Collaborative — Introducing: Universal Provider Request for Claim Review Form January 2019 Category Documentation Requirement

Category: Health Go Health

MASSACHUSETTS STANDARD FORM FOR MEDICATION …

WEBharm to the member? ☐ Yes No If yes, briefly describe details of contraindication, adverse reaction, or harm: Is the alternative drug required under the step therapy protocol …

Category: Health Go Health

BEHAVIORAL HEALTH — LEVEL OF CARE REQUEST FORM

WEBPartial Hospitalization ☐ Community Stabilization/Treatment (☐ ICBAT ☐ CBAT ☐ CCS/CSU) ☐ Residential ☐ Outpatient Psychotherapy (except 90837/90838) ☐ …

Category: Health Go Health

MASSACHUSETTS MEDICAL PRICE TRANSPARENCY LAW AND …

WEBMassachusetts Collaborative — Price Transparency Information Worksheet January 2015 COST ESTIMATE WORKSHEET PATIENT INFORMATION (TO BE COMPLETED BY …

Category: Health Go Health

REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION …

WEB2 Massachusetts Collaborative — Repetitive Transcranial Magnetic Stimulation Request Form January 2019

Category: Health Go Health

STANDARDIZED PROVIDER INFORMATION CHANGE FORM

WEBSTANDARDIZED PROVIDER INFORMATION CHANGE FORM (CONTINUED) Provider Name: SUBMISSION INFORMATION: Blue Cross Blue Shield of MA Provider …

Category: Health Go Health

Introducing: Standardized Prior Authorization Request Form

WEBIntroducing: Standardized Prior Authorization Request Form The Massachusetts Health Care Administrative Simplification Collaborative*, a multi‐stakeholder group

Category: Health Go Health

STANDARDIZED PROVIDER INFORMATION CHANGE FORM

WEB2 Massachusetts Collaborative — Standardized Provider Information Change Form July 2023 4. PRACTICE STATUS:May be impacted by contract terms and follow-up may be …

Category: Health Go Health

CARDIAC IMAGING PRIOR AUTHORIZATION FORM

WEB2 Massachusetts Collaborative — Cardiac Imaging Prior Authorization Form April 2019 (version 1.0)

Category: Health Go Health

Request for Claim Review Form

WEBMassachusetts Administrative Simplification Collaborative–Request for Claim Review V1.1 Request for Claim Review Form Today’s Date (MM/DD/YY): Health Plan Name:

Category: Health Go Health