PCCM PCP/Member Assignment validation by Providers – due date June 17th, 2011

June 16, 2011

MaineCare has been working to correct the Primary Care Case Management (PCCM) Primary Care Provider (PCP) panel reports.

PCCM Providers began receiving their May 2011 member panel report the week of May 9th. The PCP/member assignment information must be reviewed and verified.

The due date for responses is June 17th, 2011. If we have not received a response by this time, it will be assumed that there are no changes to the panel report.

A letter has been sent from MaineCare to Pay-To PCCM provider locations. The letter contains instructions on how to review, update and return the May panel report. It was sent to the contact person listed on the provider enrollment documents. The panel report should be distributed to the responsible individual(s) to verify the PCCM PCP/member assignments are correct.

  • For Providers who are enrolled Trading Partners, panel reports are available in Excel format online. It can be retrieved by logging into Trading Partner accounts on My Health PAS Online Portal.

  • From the Trading Partner tab, go to File Exchange, Reports, and then PCP Roster. Then, select the link labeled “PCCM PCP Data” to obtain your spreadsheet-based panel report that can be downloaded to your computer.

  • The spreadsheet contains two tabs. The first tab is the READ ME tab that contains instructions. The second tab contains the Provider NPI number and the PCCM Panel Report data.

  • For Providers who are not Trading Partners, the panel report was sent through the U.S. Postal Service.

If there are questions about your panel report after reviewing it, contact Provider Services at 1-866-690-5585.