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BUREAU INFORmaTION
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Home > Provider > Managed Care Primary Care Case Management (PCCM)
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| Overview of Primary Care Case Management (PCCM) | Documents | PDFs or Other |
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| How to Become a PCP | Documents | PDFs |
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| Adding a New PCP | Documents | PDFs |
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| Billing Procedures | Documents | PDFs |
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| Exempt Diagnostic and Procedure Codes | Documents | PDFs |
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(May 2008)
Implemented in the fall of 2000, the Primary Care Provider Incentive Payment (PCPIP) continues to provide additional compensation to providers who deliver high quality healthcare to their patients and who rank above the 20th percentile for certain measures when compared to other physicians within their specialty. The goals of PCPIP: (1) Increase Access of MaineCare members to providers. (2) Reduce unnecessary/inappropriate ER utilization, and, (3) Increase utilization of preventive/quality services. Providers whose primary specialty is Family Practice, General Practice, Pediatrics, Obstetrics/Gynecology, or Internal Medicine and who are practicing primary care are eligible for the payment. Along with the bi-annual payment, a detailed report showing practice utilization review from MaineCare paid claims data is run for each billing number. The report shows performance measures compared amongst same specialty groups as a whole for MaineCare managed care populations as well as for tradition Fee-for-Service. Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC) and providers who receive cost settlement payments do not qualify for PCPIP but do receive the utilization review report.
| Primary Care Provider Incentive Payment (PCPIP) | Documents | PDFs |
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Note:If you can not read the above files you can use these links to access Word Viewer for .doc files or Adobe Acrobat for .pdf files.
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