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    • Planned Disaster Recovery Testing from 8:00 AM Saturday October 11th to 12:00 PM October 13th - October 7, 2014

      MIHMS and the Health PAS Online Portal will be unavailable from 8:00 AM on Saturday, October 11, 2014 through Monday, October 13, 2014 at 12:00 PM (noon). MaineCare will perform a scheduled Disaster Recovery Test on the system during this time.

      Payment processing cycle impact:

      • Claims adjudicated during the October 4th cycle starting at 12:01 AM through noon October 9th (6 days) will be paid on October 15th. • Claims adjudicated during the October 9th cycle starting at 12:01 PM through October 17th at noon (8 days) will be paid on October 22rd. Claims adjudicated during October 18th cycle, will return to seven (7) day processing and payment cycles. During the test period, the Health PAS Online Portal will be unavailable. Providers and billing agents can: • Check MaineCare eligibility through the Interactive Voice Response (IVR) by calling 1-866-690-5585. Eligibility verification data will be current as of Friday, October 10th. - Expect payments to be on the regular weekly schedule, but please note:

      • Payments for the week ending October 10th will include six (6) days of claims rather than a full week.
      • Payments for the week ending October 17th will include eight (8) days of claims rather than a full week.
      • Electronic Fund Transfer (EFT), PDF Remittance Advices (RAs) and 835s will not be affected. Paper RAs and checks will be on schedule.
      • The portal will be available until 8:00 AM on Saturday, October 11th so that you can download your 835s prior to the scheduled downtime.
      • For the entire period of the Disaster Recovery exercise, the maintenance page will be displayed on the portal. While the Health PAS Online Portal is unavailable, providers and billing agents cannot:

      • Submit Direct Data Entry (DDE) or electronic claims

      • View any portal documents
      • Retrieve a PDF RA or 835
      • Perform a new provider enrollment or submit a maintenance case for an existing enrollment
      • Use any portal functionality (Including 837, 270 or 271 submissions)
         

    • Primary Care Provider (PCP) Utilization Review (UR) Report - October 7, 2014

      The PCP UR Report for the reporting period of 01/01/2013 – 12/31/2013 will be available on the MyHealth PAS Online Portal on October 10, 2014. To access the report, go to the Health PAS Online Portal and sign in to the secure trading partner page. Then, go to File Exchange > Reports > Other Reports.

      All PCCM PCPIP and UR Reports are now posted on the portal at the above location and only mailed to those providers who do not have a Trading Partner Account.

      For questions, please email PCP Network Services.

         

    • Fee Schedule Changes, CR 19681 - October 14, 2014

      MaineCare will be changing the way the fee schedules are posted on the Health PAS Online Portal. They will no longer be posted as tabs within one file. They will now be posted as individual files in three different formats, CSV, .PDF and EXCEL (2003). Before using this new version of the fee schedules, please take some time to read the MaineCare Fee Schedule Preface (found with the fee schedule) for important information regarding the use of the fee schedules. The files will be updated weekly, on Mondays, beginning October 20, 2014.

      You can find the fee schedule in the Provider Fee Schedule folder on the Health PAS Online Portal.

      Some tips for using these files:

      • CSV can be saved to any version of EXCEL
      • We recommend using freeze top row view in EXCEL
      • We recommend that you enable filtering under the data menu
      • We do not recommend working with printed versions because these files are updated weekly and these documents are very large
      • If you need to print these files, we recommend that you set the header row to repeat
         

    • Code and Rate Additions, Deletions, and Corrections - October 14, 2014

      The “Code and Rate Additions, Deletions, and Corrections” spreadsheets have recently been updated. The spreadsheets are used to notify you of code and rate changes. You can view these spreadsheets on the "Claims, Billing, and Enrollment webpage. We will send a listserv update when new information is added.

         

    • Re-Opening of Practice Application for Participation in Stage A Health Homes, Serving Members with Chronic Physical Conditions - October 15, 2014

      Please see corrected application link (https://www.surveymonkey.com/s/HHPApplicationJan2015) in red below: Health Homes are an important component of Maine’s Value-Based Purchasing strategy, a multi-pronged MaineCare initiative designed to improve the health care system, improve population health, and reduce cost. Modeled after Maine’s Multi-Payer Patient Centered Medical Home Pilot, Health Homes partner with Community Care Teams and Behavioral Health Home organizations to serve MaineCare members with chronic physical conditions and members with serious mental health needs. Participating practices receive $12.00 per member, per month to provide population-based Health Home services to MaineCare members with chronic conditions, and $15.00 per member per month for MaineCare members with serious mental health needs. Both adults and children may be enrolled in the Health Home program. Applications open Wednesday, October 15, 2014 and close Friday, November 14, 2014. Practices with more than one location must complete a separate application for each location. To access the online application on or after October 15, please go to: "https://www.surveymonkey.com/s/HHPApplicationJan2015">https://www.surveymonkey.com/s/HHPApplicationJan2015">"https://www.surveymonkey.com/s/HHPApplicationJan2015
      - Practices that apply and qualify will be eligible to participate in both Stage A and Stage B Health Home Programs as of January 21, 2015. Practices that are already participating in Stage A Health Homes do no need to apply to participate in Stage B. These practices may contact MaineCare with any questions about participation in Stage B. To review the current MaineCare regulation on Health Homes, please go to: < a href="http://www.maine.gov/sos/cec/rules/10/144/ch101/c2s091.doc">http://www.maine.gov/sos/cec/rules/10/144/ch101/c2s091.doc

      • A webinar for interested primary care providers will be held on Friday, October 24, at 12:00 PM. To register for the webinar, please send your organization’s name, participant name, phone and email to HH-BHH-Services.DHHS@maine.gov
      • Additional information about the Health Home and Behavioral Health Home initiatives can be found at MaineCare's Value-Based Purchasing website: http://www.maine.gov/dhhs/oms/vbp/index.html
         

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          • Planned Disaster Recovery Testing from 8:00 AM Saturday October 11th to 12:00 PM October 13th - October 7, 2014

            MIHMS and the Health PAS Online Portal will be unavailable from 8:00 AM on Saturday, October 11, 2014 through Monday, October 13, 2014 at 12:00 PM (noon). MaineCare will perform a scheduled Disaster Recovery Test on the system during this time.

            Payment processing cycle impact:

            • Claims adjudicated during the October 4th cycle starting at 12:01 AM through noon October 9th (6 days) will be paid on October 15th. • Claims adjudicated during the October 9th cycle starting at 12:01 PM through October 17th at noon (8 days) will be paid on October 22rd. Claims adjudicated during October 18th cycle, will return to seven (7) day processing and payment cycles. During the test period, the Health PAS Online Portal will be unavailable. Providers and billing agents can: • Check MaineCare eligibility through the Interactive Voice Response (IVR) by calling 1-866-690-5585. Eligibility verification data will be current as of Friday, October 10th. - Expect payments to be on the regular weekly schedule, but please note:

            • Payments for the week ending October 10th will include six (6) days of claims rather than a full week.
            • Payments for the week ending October 17th will include eight (8) days of claims rather than a full week.
            • Electronic Fund Transfer (EFT), PDF Remittance Advices (RAs) and 835s will not be affected. Paper RAs and checks will be on schedule.
            • The portal will be available until 8:00 AM on Saturday, October 11th so that you can download your 835s prior to the scheduled downtime.
            • For the entire period of the Disaster Recovery exercise, the maintenance page will be displayed on the portal. While the Health PAS Online Portal is unavailable, providers and billing agents cannot:

            • Submit Direct Data Entry (DDE) or electronic claims

            • View any portal documents
            • Retrieve a PDF RA or 835
            • Perform a new provider enrollment or submit a maintenance case for an existing enrollment
            • Use any portal functionality (Including 837, 270 or 271 submissions)
               

          • Primary Care Provider (PCP) Utilization Review (UR) Report - October 7, 2014

            The PCP UR Report for the reporting period of 01/01/2013 – 12/31/2013 will be available on the MyHealth PAS Online Portal on October 10, 2014. To access the report, go to the Health PAS Online Portal and sign in to the secure trading partner page. Then, go to File Exchange > Reports > Other Reports.

            All PCCM PCPIP and UR Reports are now posted on the portal at the above location and only mailed to those providers who do not have a Trading Partner Account.

            For questions, please email PCP Network Services.

               

           

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