Section 450.309 - Time Limitation on Submission of Claims: General Requirements(A) In accordance with M.G.L. c. 118E, § 38, all claims must be received by the MassHealth agency within 90 days from the date of service or the date of the explanation of benefits from another insurer. When a service is provided continuously on consecutive dates, the date from which the 90-day deadline is measured is the latest date of service.(B) For claims that are not submitted within the 90-day period but that meet one of the exceptions specified below, a provider must request a waiver of the billing deadline (a 90-day waiver) pursuant to the billing instructions provided by the MassHealth agency. The exceptions are as follows: (1) a medical service was provided to a person who was not a member on the date of service, but was later enrolled as a member for a period that includes the date of service;(2) a medical service was provided to a member who failed to inform the provider in a timely fashion of the member's eligibility for MassHealth; and(3) other exceptions that are expressly authorized by the MassHealth agency pursuant to a MassHealth transmittal letter or provider bulletin.(C) When a medical service was provided to a MassHealth member in another state by a provider that is not enrolled in MassHealth, the MassHealth agency will consider a claim for such service to have been timely submitted if all of the following apply: (1) the medical service was provided in accordance with 130 CMR 450.109;(2) the provider submits an application to the MassHealth agency to become a participating provider within 90 days after the date of service and the MassHealth agency approves the application; and(3) the provider submits the claim for payment within 90 days after the date of the notice from the MassHealth agency approving the provider's application.(D) All requests for waivers of the billing deadline submitted to the MassHealth agency for review must be submitted electronically in a format designated by the MassHealth agency, unless the provider has been approved for an electronic claim submission waiver as specified in 130 CMR 450.302(A)(3).Amended by Mass Register Issue 1341, eff. 6/16/2017.Amended by Mass Register Issue 1373, eff. 6/16/2017.Amended by Mass Register Issue 1374, eff. 10/1/2018.