Dates of service for Senior Whole Health of Massachusetts

January 1, 2022

Beginning January 1, 2022, Senior Whole Health of Massachusetts is now available in Availity Essentials for information and tools from Senior Whole Health and other participating payers.

Refer to the following table when running a certain transaction or using a service in Availity Essentials for the dates of service prior to, on, and after 1/1/2022:

1

What are you trying to do?

2

On what dates can I do this in Availity Essentials?

3

In Availity Essentials, follow this workflow and select Senior Whole Health of Massachusetts.

3

Identify the Availity role you need...

Verify a patient's eligibility and benefits.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.

Patient Registration > Eligibility and Benefits Inquiry

Eligibility & Benefits

Review patient care reminders from the Eligibility and Benefits Results page.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.

  1. Patient Registration > Eligibility and Benefits Inquiry

  2. On the Eligibility and Benefits Results page, click the Care Reminders tab to review care reminders for the patient.

Eligibility & Benefits

Ask a question about the patient’s eligibility and benefits. I need to send a message to the payer from the Eligibility and Benefits Results page.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.

Send a message to the payer

  1. Patient Registration > Eligibility and Benefits Inquiry

  2. On the Eligibility and Benefits Results page, click Message this payer.

Access messages sent from the payer

Availity home page > messaging app

Eligibility and Benefits

Messaging app

Messaging app - admin

Ask a question about the patient’s claim status I need to send a message to the payer from the new Claim Status Results page.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.

Send a message to the payer

  1. Patient Registration > Claim Status > Claim Status Inquiry

  2. On the Claim Status Results page, click Message this payer.

Access messages sent from the payer

Availity home page > messaging app

Claim Status

Messaging app

Messaging app - admin

Verify the status of a patient's claim.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.

Claims & Payments > Claim Status

Claim Status

Add a medical attachment to my claim.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.

Workflow #1

  1. Initiate a claim and send attachment(s): Claims & Payments > Professional Claim or Facility Claim

  2. Select the ATTACHMENTS option and follow prompts to add the file.

  3. Track the attachment: Claims & Payments > Attachments - New > Sent and History tabs.

Workflow #2

Claims & Payments > Attachments - New > Send Attachment

Medical Attachments

Review remittance information.

For dates of service on or after 1/1/2022, use Availity Essentials to perform this function. For dates of service prior to 1/1/2022, please contact Molina Provider Services.
Note: You will be able to download and view EOPs mid-January 2022.
  1. Claims & Payments > Remittance Viewer > Remittance Viewer

  2. Search remittances by claim number.
  3. In remittance viewer, click the Claim tab.

Claim Status

Submit a professional claim for a patient.

For dates of service prior to 1/1/2022, please submit claims via EDI or mail to Senior Whole Health of Massachusetts.
  1. Claims & Payments > Professional Claim

  2. In the Transaction field, select Professional Claim.

Claims

Submit an institutional claim for a patient.

For dates of service prior to 1/1/2022, please submit claims via EDI or mail to Senior Whole Health of Massachusetts.
  1. Claims & Payments > Facility Claim

  2. In the Transaction field, select Facility Claim.

Claims