New Mental Health Clinic Medical Director Requirment

March 16, 2012

New Mental Health Clinic Medical Director Requirement

In accordance with the March 15th “[Provider] 2012 DHHS Supplemental Budget Notice” ListServ, this notice serves to explain what Mental Health Clinics operating under Section 65 of the MaineCare Policy Manual must do to maintain their enrollment with MaineCare. This notice applies to all providers enrolled as a Mental Health Clinic (MHC) with a specialty of Behavioral Health Services (BHS).

Your immediate response is required. Please contact Provider Enrollment by calling 866-690-5585 (TTY: 711), option 1, by fax: 877-314-8776 or by email at: .

You will need the following information: - Medical Director Name
- Medical Director NPI
- Medical Director License # - Verification that the Medical Director is enrolled as a rendering provider to the MHC and affiliated to all BHS service locations - Or verification that there is no Medical Director on staff

MIHMS Provider Enrollment staff is available from 7:00 am to 6:00 pm, Monday through Friday.

If the Medical Director is not enrolled in MaineCare, please immediately submit a maintenance case to enroll the Medical Director as a rendering provider to your MHC/BHS facility to ensure that proper claim payment will continue. On March 31, 2012, Mental Health Clinics with a Behavioral Health Specialty that have not enrolled an approved Medical Director will have that portion of their enrollment end dated. Claims for dates of service after 3/31/2012 will be held for 21 days to allow time for your Medical Director’s enrollment to be approved. Claims will be released upon approval of your Medical Director. If a Medical Director enrollment is not received, approved and completed within 21 days, the MHC claims will be denied.

If you do not have a Medical Director on staff, please discontinue billing MHC/BHS services for dates of service on and after April 1, 2012. Please immediately submit a maintenance case to enroll the Service Location as a Provider Type 11 Behavioral Health Clinician or a Provider Type 12 Behavioral Health Group to ensure minimum disruption to proper claim payment.

MIHMS Provider inquiries can be directed to 1-866-690-5585.