Provider Enrollment Application (PEA) Supporting Document Process Update, CR 122384

MIHMS is now only accepting supporting documents uploaded in PEA. We removed the E-mail, Fax, and Mail options. This enhancement will streamline the enrollment process and reduce the number of cases sent back to the provider due to lack of necessary documentation. 

If you have any questions, please contact Gainwell Provider Services by:

Email: mainecareprovider@gainwelltechnologies.com

OR

Phone: 1-866-690-5585.

 

Section 67, Nursing Facilities (NFs) Draft Rate Methodology (Part 1 & 2): Presented Materials and Comment Deadline

On March 7 and 8, 2024, MaineCare held a two-part, online public meeting with its vendor, Guidehouse, to present the recommended draft rate methodology and rationale for NFs. Interested parties asked questions and made public comments during these forums.    

Electronic Visit Verification (EVV) Phase 2 Trainings

The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.

We continue to offer weekly EVV provider and aggregator trainings. All trainings are online via Microsoft Teams.

NOTE: The Absorb training system has been updated to allow providers to register for trainings more than once.

EVV Training Schedule

EVV Phase 2 Training and Aggregator Content – State and Provider Trainings

 

Attention Section 45 Hospital Service  Providers: February 26, 2024, Forum Presented Materials

On February 26, 2024, MaineCare with its vendor HMA - Burns, held a second virtual public forum to present draft reimbursement methodologies and rationales for outpatient core facility services in acute care and rehabilitative hospitals. At this forum, HMA – Burns also presented a draft methodology for inpatient and outpatient core facility services in critical access hospitals (CAHs).

Palliative Care Interdisciplinary Team Services (Section TBD) - Rate Study Kickoff Meeting and Staff Survey Overview

As previously shared in our October 13, 2023, bulletin, the Department initiated a rate determination process for a new service model under review for future proposal. As a result of that process, we are now conducting a rate study.

You are receiving this email because we are inviting you to participate in the rate study process for this service.

Attention Section 18, 21, and 29 Providers: Evergreen Users Billing 837 Claims

With the new Evergreen system rollout, previous authorizations with a prefix of “EIS” have been replaced by new authorizations with a prefix of “LTS.”   

Our current Electronic Data Interchange (EDI) 837 file was developed with a max of 15 characters for authorization IDs. The new LTS authorization IDs have a max of 17 characters. When submitting 837 claims, providers are reporting that the last two characters of the authorization ID are getting cut off, resulting in denied claims with the “UM not found” edit.   

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