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The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the p
We have resolved the timing out and extended wait time issues that providers reported experiencing on the Health PAS Online Portal.
We apologize for any inconvenience these issues may have caused you.
We have identified a defect in Edit 6075 logic which is causing some claims submitted by Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), Indian Health Services (IHS) providers, and School Health Center providers with paid encounter services to incorrectly deny the T1015 service. We will notify you when this issue is corrected and affected claims will be reprocessed. No provider action is needed.
Please contact your Provider Relations Specialist, Tia Bolduc, with any questions.
The Office of Behavioral Health (OBH), in coordination with Kepro, have updated the definitions of a Critical Incident to better clarify when it must to be reported through the Kepro Atrezzo system.
COVID-19 vaccination remains the best way to prevent infection, hospitalization, and death. COVID-19 vaccination is recommended for individuals five years and older; a booster dose is recommended for individuals 12 years and older, and a second booster is authorized for individuals 50 years and older.
Patients who are moderately or severely immunocompromised should receive additional vaccine doses and may also receive pre-exposure prophylaxis to further reduce the risk of infection, hospitalization, and death.
The Office of Child and Family Services (OCFS), in partnership with the Office of MaineCare Services (OMS), developed a MaineCare policy for Children’s Psychiatric Residential Treatment Facility (PRTF) services under the MaineCare Benefits Manual, Section 107, in 2018.
We understand you may be experiencing issues with the Health PAS Online Portal. You may have extended wait times, timing out of applications, and no response when attempting to view and submit prior authorizations, adjusting claims, or accessing certification submissions.
We are working to correct the issues as soon as possible and will send another message when they are resolved.
Please contact Provider Services with questions by email or call 1-866-690-5585.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the propo
As of May 20, 2022, we have updated Prior Authorizations (PAs) issued prior to May 3, 2022, for Section 21 Home Support- Agency Per Diem (T2016 or T2016 SC) rate adjustments effective January 1, 2022, associated with Part AAAA of P.L. 2021, ch 398. Providers may now adjust claims for these services retroactively to January 1, 2022. Providers have 120 days from the date of this notice to adjust claims; please focus on the oldest dates of service first.
Effective immediately, all providers submitting claims for Individuals with Disabilities Education Act (IDEA) services must include the TL or TM modifier on the claim line to indicate if the service was provided pursuant to an Individualized Education Program (IEP) or Individual Family Service Plan (IFSP), respectively.
TL and TM modifiers must now be included for claims submitted for any and all services delivered under MaineCare Sections 28 and 96 of MBM.