PRIMARY CARE CASE MANAGEMENT (PCCM) REFERRAL WARNING UPDATE

December 28, 2012

Providers will continue to see WARN on their Remittance Advice (RA) when a referral is needed for claims with dates of service on or after 1/1/2013. This is to allow for additional testing of the referral function. We will notify you when the WARN period will end. (Note: this is a change from a previous listserv that states the WARN period will end on 12/31/2012.)

As a reminder, referrals must still be kept in the member’s record for record keeping purposes. We will continue to provide updates on the status of PCCM referrals. Providers who are able to successfully submit referrals, must continue to do so. Likewise, we recommend that specialists verify the presence of referrals in the Health PAS Online Portal prior to rendering services. If you are not able to submit or view referrals, please contact Provider Services at 1-866-690-5585.

If you have questions about the PCCM program or about being a PCCM PCP, please contact PCP Network Services at PCP-Network-Services.DHHS@maine.gov or at(207) 287-3320 or (207) 287-6349.

If you have questions about referrals, please contact Provider Services at: 1-866-690-5585.