MaineCare is currently in the process of transitioning to a fiscal agent model of operation that will include implementation of a Medicaid Management Information System (MMIS). We are on track with a scheduled implementation of this MMIS by January 2010. It is not anticipated that any HIPAA transactions will supported by the current system (MeCMS) prior to the transition to the new Fiscal Agent. This includes the 837 HIPAA Claims: Professional, Dental, or Institutional.
Below are important documents and links relating to MECMS. Please read.
| News Items |
File Type Word |
File Type Other |
Behavioral Health Services |
|
|
- ICI Provider clarification
|
|
|
- ICI Provider Clarification
|
(.doc) |
(.pdf) |
- Managed Care Behavioral Health
|
|
|
- APS Maine Behavioral Health Administrative Services Organization Presentation
|
|
(.ppt) |
- Targeted Case Management Changes
- Information regarding the Targeted Case Management Rule delay can be found in the June 2008 listserv messages. The link is listed below.
|
| |
|
|
Note: Additional information on this topic is contained within listserv messages:
|
|
|
| |
|
|
| Back to Top |
|
|
Centers for Medicare and Medicaid (CMS) Rule Changes |
|
|
- Certified Seed/Governmental Status of Health care Providers Survey
|
|
|
| |
|
|
| |
|
|
Code Updates |
|
|
|
|
|
- National Uniform Billing Committee Codes Updates
|
(.doc) |
(.pdf) |
- Claim Adjustment Reason Codes and Remittance Advice Remarks Codes Updates
|
(.doc) |
(.pdf) |
| |
|
|
Note: Additional information on this topic is contained within listserv messages:
|
|
|
| |
|
|
| Back to Top |
|
|
Financial Information |
|
|
- Claims Hold For Recovery of Interim Payments
|
|
|
|
|
(.pdf) |
- Frequently Asked Questions
|
(.doc) |
(.pdf) |
- Claims Portal Instructions
|
(.doc) |
(.pdf) |
- Information on Release of Claims from Claims Hold Recovery
|
(.doc) |
(.pdf) |
- OMS Weekly Financial Update
|
|
|
|
(.doc) |
(.pdf) |
|
(.doc) |
(.pdf) |
|
(.doc) |
(.pdf) |
|
(.doc) |
(.pdf) |
|
|
|
| |
|
|
Note: Additional information on this topic is contained within listserv messages:
|
|
|
| |
|
|
Fiscal Agent |
|
|
- Accelerated Provider Reenrollment Project
|
|
|
- Letter to Providers for Re-enrollment 05/23/2008
|
|
(.pdf) |
- Re-enrollment Frequently Asked Questions 06/03/2008
|
(.doc) |
(.pdf) |
| |
|
|
| Back to Top |
|
|
MeCMS Repair Initiatives |
|
|
|
|
|
- Provider Instructions - Adjustments 03/02/2008
|
(.doc) |
(.pdf) |
- Adjustments Discontinue Checks 02/01/2008
|
(.doc) |
(.pdf) |
- Cost of Care/Copay/Modifiers/Edits Processing Failure (CCME)
|
|
|
- Cover Letter for 01/21/2008 Repair Bundle
|
(.doc) |
(.pdf) |
- Letter to Providers Regarding Services that Require Copays
|
(.doc) |
(.pdf) |
- Cost of Care/Copay/Modifiers/Edits Processing Failure
|
(.doc) |
(.pdf) |
- MECMS Limits Functionality
|
|
|
- Limits Functionality Provider Instructions
|
(.doc) |
(.pdf) |
- Void Functionality to be Implemented in MeCMS
|
|
|
- MaineCare Contacts for Claims Adjustments
|
(.doc) |
(.pdf) |
- MeCMS Void Provider Presentation (10/31/2007)
|
|
(.ppt) |
- MeCMS Void Functionality Instructions (10/25/2007)
|
(.doc) |
(.pdf) |
- Overview of Voids Functionality in MeCMS (10/25/2007)
|
(.doc) |
(.pdf) |
- Cover Letter: Norman Curtis (09/24/2007)
|
(.doc) |
(.pdf) |
- Cover Letter: Tony Marple (09/14/2007)
|
(.doc) |
(.pdf) |
- Appendix I: Provider Training Details (09/14/2007)
|
(.doc) |
(.pdf) |
- Appendix II: Electronic Claims FAQ's (09/14/2007)
|
(.doc) |
(.pdf) |
- Appendix III: Voids Information for Cost-Settled Providers (09/14/2007)
|
(.doc) |
(.pdf) |
| |
|
|
Note: Additional information on this topic is contained within listserv messages:
|
|
|
| |
|
|
| Back to Top |
|
|
Member Information |
|
|
- Member Letter and Frequently Asked Questions Document
|
|
|
- MaineCare Change to Services - Letter to Members
|
(.doc) |
(.pdf) |
- Frequently Asked Questions and Answers document
|
(.doc) |
(.pdf) |
| |
|
|
Pediatric Services |
|
|
- Pediatric Specialty Services Letter and List
|
|
|
- MaineCare Primary Providers and Specialists
|
(.doc) |
(.pdf) |
- Pediatric Specialty Services Available in Maine
|
(.doc) |
(.pdf) |
| |
|
|
| |
|
|
Physician Administered Drugs |
|
|
- MaineCare Compliance with Centers for Medicare and Medicaid Services (CMS) Regulations for Physician-Administered Drugs
|
|
|
- Communication to Providers - J Code Issue - Reporting Requirement Postponed
|
(.doc) |
(.pdf) |
- NDC Letter From Tony Marple
|
(.doc) |
(.pdf) |
- Top 20 Physician Administered Drugs
|
|
(.pdf) |
- Physician-Administered Drugs
|
(.doc) |
(.pdf) |
| |
|
|
Note: Additional information on this topic is contained within listserv messages:
|
|
|
| |
|
|
| Back to Top |
|
|
Policy Updates |
|
|
- Sections 21 and 29 Implementation
|
|
|
Emergency Rules |
|
|
|
(.ppt) |
(.pdf) |
- Questions and Answers On Rates and Transportation Related to MR Waivers
|
(.doc) |
(.pdf) |
- December 6, 2007 Update on Comprehensive Waiver Section 21- Jane Gallivan Update to Providers
|
(.doc) |
(.pdf) |
- October 22, 2007 Update on Support Waiver Section 29
|
(.doc) |
(.pdf) |
- October 22, 2007 Update on Comprehensive Waiver, Section 21
|
(.doc) |
(.pdf) |
- October 5, 2007 Update on Comprehensive Waiver, Section 21
|
(.doc) |
(.pdf) |
- October 4, 2007 Update on Support Waiver, Section 29
|
(.doc) |
(.pdf) |
|
|
|
- Letter to Section 58 Providers
|
(.doc) |
(.pdf) |
| |
|
|
Note: Additional information on this topic is contained within listserv messages:
|
|
|
| |
|
|
| Back to Top |
|
|
Primary Care Physician Rates |
|
|
- Primary Care Physician Rates
|
|
|
- Physician Fee Increase Spreadsheet 05/20/2008
|
(.xls) |
(.pdf) |
| |
|
|
| |
|
|
Schaller Anderson |
|
|
- Schaller Anderson Services
|
|
|
- Geoff Green Letter to Home Health Agencies
|
|
(.pdf) |
- Home Health Frequently Asked Questions
|
(.doc) |
(.pdf) |
- Geoff Green Letter to Outpatient Therapies
|
|
(.pdf) |
- Geoff Green Letter to Rehab Facilities
|
|
(.pdf) |
| |
|
|
| |
|
|
Timely Filing |
|
|
|
(.doc) |
(.pdf) |
| |
|
|
| |
|
|
