What happens if a copayment is deducted from my MassHealth payment in error?
If a pharmacy provider believes that a copayment was incorrectly deducted from a claim, the provider can void and replace the claim on POPS. If a hospital believes that a copayment was incorrectly deducted from a claim, the hospital may submit an adjustment claim. For a hospital claim where a copayment was taken for a pregnant member, the hospital can adjust the claim by ensuring that a pregnancy diagnosis code is indicated on the claim and submit an adjusted claim to MassHealth. If a hospital believes that a copayment was incorrectly deducted from a claim for a reason other than pregnancy, the hospital can submit the adjusted claim to the address below with a written explanation.
