Important: MIHMS Will Be Unavailable January 13-16
January 6, 2012
Important: MIHMS Health PAS Online Portal Will Be Unavailable January 13-16
MaineCare will perform scheduled maintenance to the MIHMS (Maine Integrated Health Management Solution) system from 12:01 am on Friday, January 13 through 7:00 am on Tuesday, January 17, in preparation for HIPAA Version 5010. The MIHMS Health PAS Online Portal will be unavailable during this time.
During this maintenance, providers and billing agents –
• Check Medicaid eligibility through the Interactive Voice Response (IVR) by calling MaineCare at 1-866-690-5585. Eligibility verification data will be current as of Thursday, January 12.
• Submit an “Urgent” Prior Authorization (PA) * request by taking the following action:
o Call Provider Services at 1-866-690-5585 and say you need to submit an Urgent PA request. Indicate the service type, i.e., out-of-state medical service, out-of-state transportation, etc.
Your call will be transferred to the appropriate PA unit and you will be given specific instructions. Do not submit your Urgent request to the MIHMS PA fax number.
• Expect payments to be on the regular weekly schedule.
o Payments for the week ending January 27 will include four days of claims rather than a full week.
o Depending on the claims volume, processing will return to normal over the next one or two weeks. • Expect that Electronic Fund Transfer (EFT) to be unaffected; however, PDF Remittance Advices (RAs) and 835s will not be available until January 17. • Expect paper Remittance Advices (RAs) and checks on schedule. • Expect additional list serve messages or RSS Feeds on the status. • Call the EDI Helpdesk at 1-866-690-5585, option 3.
While the MyHealthPAS online portal is unavailable, providers and billing agents— Cannot: • Get to the portal home page • Log in to the portal (Trading Partner log in) • Submit DDE or electronic claims • View any portal documents • Retrieve a PDF Remittance Advice or 835 • Use any portal functionality
Please note that HIPAA Version 5010 transactions will not be accepted prior to January 17, 2012, even if the trading partner is certified. After the maintenance period, uncertified trading partners may continue to submit test transactions until they accomplish certification, at which time they will be allowed to submit production transactions. MaineCare is committed to minimizing the disruption to providers during this time and thanks you in advance for your patience.
- “Urgent” care is medical care to treat persons who have an injury or illness that requires immediate care but is not serious enough to warrant a visit to an Emergency Department. Examples include out-of-state outpatient services or physician office services that are medically needed within an immediate timeframe. “Emergency” out-of-state services will be processed as usual, on a retroactive basis. Providers must notify the Department by calling 1-866-796-2463, within one business day of an emergency inpatient admission for a MaineCare member.