Provider Manual for Mass Advantage Medicare Advantage Program

This online provider manual provides information on the Mass Advantage Medicare Advantage program and associated policies for participating providers to follow.   

Mass Advantage was built by local providers for local people and the Mass Advantage philosophy is “Plan to Love Your Plan”; our provider network is an essential component of that promise. Mass Advantage is committed to partnering with our providers to remove the administrative burden so that you can spend more time caring for your patients in a way that best meets their needs. We’ve worked hard to develop our plan policies with our providers in mind and developed this manual as a reference and resource for Mass Advantage’s provider network.

Close up of pen signing a check

Mass Advantage Benefits information Medical, Pharmacy, and Supplemental Benefits across all 3 Mass Advantage Plan Products.

Mass Advantage contracts with primary and specialty care providers, hospitals, and ancillary providers to care for our members. The following sections outline the basic guidelines for our network providers.

Care Coordination is a key component of Mass Advantage operations. Mass Advantage facilities optimal settings for delivery of care and educates physicians and facilities on the advantages of managing care in a medically appropriate and cost-effective manor. In addition, Mass Advantage collaborates with providers, vendors, and community resources to keep members living safely at home.

Mass Advantage members have the right to communicate dissatisfaction with the quality of care that they receive, the timeliness of services, or decisions made by Mass Advantage or its providers. CMS separates these into two categories: grievances and appeals.

Mass Advantage maintains billing and claims processing guidelines consistent with industry standards. This section contains billing and claims guidelines for claims filed with Mass Advantage. Providers must follow these guidelines to ensure accurate and timely payments.

When it comes to your patient’s health information, they have certain rights. These pages explain your patient’s rights and some of our responsibilities to help them as Mass Advantage members.

Mass Advantage deploys both quality and clinical programs to enhance the quality of care their members receive. These programs include both Medical and Pharmacy-related programs, such as the Medicare Advantage and Part D Star Ratings program and Medication Therapy Management (MTM) program. Learn more about the Quality and Clinical programs Mass Advantage deploys.


We’re here to help.  

HMO: (844) 918-0114 

PPO: (844) 915-0234 

TTY: 711 

From October 1 to March 31, we’re available 7 days a week from 8 am to 8 pm EST. From April 1 to September 30, we’re available Monday through Friday from 8 am to 8 pm EST.

Or, email us at