ATTN: Durable Medical Equipment (DME) Crossover Claims Update

August 15, 2012

Previously, some crossover DME claims rejected because of required Medicare claim data elements PAT07/, PAT08 that are not accepted on claims submitted to MaineCare. The issue is now resolved and crossover DME claims will no longer reject for this reason.

If you have received a notice that Medicare has submitted your claim to MaineCare and you have not received payment within 30 days, your claim may not have been accepted by MaineCare. Please check your claims status report on Health PAS Online Portal. If you do not see your claim, then MaineCare did not accept it. You will need to re-submit the affected claims directly to MaineCare along with the Medicare Explanation of Benefits (EOB).

If you have any questions regarding this issue, please contact Provider Services at 1-866-690-5585.