Reporting Casualty Payer Claim Information
November 20, 2023
Providers are reminded to report casualty payer information as instructed in All Provider Bulletin 246. Casualty payer information, including any casualty payer payment or denial information, must be reported at the claim header level and should not be reported at the detail level. Providers must report the casualty payer as the primary payer at the header claim level and include the applicable MassHealth assigned carrier code.
Casualty payer carrier codes:
- 2222220 Automobile Accident; or
- 2222221 Worker’s Compensation; or
- 2222222 Other
MMIS will distribute the casualty payer header level payment among the MassHealth payable detail lines to adjudicate the claim for payment.
Claims will be denied for the following edits if the above requirements are not met:
- Edit 2639 will post if the casualty payer is not billed as the primary payer when multiple payers are reported on the claim.
- Edit 2607 will post if the casualty payer information is erroneously reported on the claim detail level not the claim header level.
If you have questions regarding this message, please contact MassHealth at provider@masshealthquestions.com or (800) 841-2900. LTSS Providers should contact the MassHealth LTSS Provider Service Center at (844) 368-5184 or support@masshealthltss.com.