Terminating a Provider as a Primary Care Provider (PCP) in MIHMS

January 10, 2014

When Primary Care Case Management (PCCM) providers change your primary care status with MaineCare, it is important to update your MIHMS enrollments. To update the PCCM status, a full maintenance case must be submitted and changes to the PCCM questions within the case must be completed.

Example:

Dr. Smith will no longer provide primary care as a MaineCare PCP as of 02/01/14. A full maintenance case needs to be completed, prior to 02/01/14, to terminate Dr. Smith’s participation in PCCM. MaineCare’s PCP Network Services will terminate Dr. Smith as a PCP in MIHMS and remove any members he has been seeing prior to 02/01/14. PCP Network Services will contact the family practice to determine if the members are staying within the practice or transferring to another.

If these updates are not received timely, necessary referrals by the correct PCP cannot be submitted and claims may not process correctly.

If you have any questions about how to complete a full maintenance case, please contact Provider Enrollment at 1-866-690-5585, Option 2 or by email at: MaineCareenroll@MolinaHealthcare.com.