Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA 02111
www.mass.gov/masshealth
MassHealth
Vision Care Bulletin 15
May 2009
TO: Vision Care Providers Participating in MassHealth
FROM: Tom Dehner, Medicaid Director
RE: New Vision Care Materials Order Form (VIS-1)
Background In preparation for NewMMIS, MassHealth has updated its Vision Care
Materials Order Form (VIS-1). Beginning May 26, 2009, providers must
begin using the updated VIS-1 form when submitting vision care material
order requests.
New Format The VIS-1 Form has been edited to conform to the new 12-digit member
and 10-digit provider identification numbers introduced as part of
NewMMIS. To simplify the vision care form ordering process, the VIS-1
form will no longer be printed on noncarbon reproduction paper.
Beginning May 26, 2009, providers can simply copy the attached VIS-1
form or download a copy from the MassHealth Web site at
www.mass.gov/masshealth
by clicking on the link titled Information for
MassHealth Providers, then MassHealth Provider Forms. This new format
also allows providers to directly enter data into certain fields before
printing the form off of the MassHealth Web site. Providers must
remember to maintain a copy of their completed VIS-1 Form requests for
their own records before mailing the original completed forms to
MassCor/Massachusetts Correctional Industries (mailing address
appears on the form).
Questions and Requests If you have any questions about the information in this bulletin, or would
like to order copies of the VIS-1 form, please contact MassHealth
Customer Service at 1-800-841-2900, e-mail your inquiry to
providersupport@mahealth.net
, or fax your inquiry to 617-988-8974.
.
