Welcome to the MaineCare's Electronic Media Claims (EMC)

What is EMC?

Electronic Media Claims (EMC) is a faster, efficient, more cost-effective method of filing MaineCare claims. Instead of filing claims on a claim form, claim information is entered into a computer and electronically transferred to our computer system using a modem and a telephone line. Electronic claims reduce MaineCare operating costs, and once you begin filing your MaineCare claims electronically, you will realize the benefits. The advantages to EMC include:

• Improved cash flow
• Access to transmission lines 24 hours a day, 7 days a week
• Less paper handling
• No postal expenses
• Increased accuracy of claims processing
• Consistent turnaround time

Methods available for filing claims electronically:

• Telecommunication involves transmitting claim information to our office over phone lines using a computer and a modem. This is the most common form of electronic claim transmission.
• Billing Services are companies that will file claims for you for a fee; usually a per copy charge. Billing services will take on the responsibility of keeping up with rapidly changing MaineCare laws as well as filing your claims electronically.
• Clearing Houses are capable of receiving various types of health insurance claims in addition to MaineCare. Once they receive the claims, the clearing house will then transfer the claims to the appropriate insurance carrier. This is an ideal option for those who want to file all claims electronically through one system.

How to obtain electronic claim capability:

• Install an office automation system. A number of software and hardware suppliers have computer systems available for filing claims electronically.
• Hire a billing service or clearing house.
• Have a system custom designed. If you are unable to locate a system that meets the needs of your office, you may want to hire a computer programmer to custom design a system for you. If so, our EMC file specifications are available.

How to Get Started Billing Electronically:

• Determine your weekly claim volume and decide which transmission alternative makes the most sense for you. Consider the possible future expansion of your practice.
• Research the products and services of software vendors, billing services and clearing houses. Request client lists from each vendor and contact offices in the same specialty as yours to rate customer satisfaction. We have several vendors available here.
• Contact the carriers to whom you will submit claims. There is a testing and approval process when beginning EMC submission. The minimum testing time is 24 hours.
• Step by Step Guide to Setting up Core FTP

How to submit pharmacy claims:

• These claims need to be handled by Goold Healt Systems. You can contact them at: 888-420-9711.

835 Remittance Advice Retrieval

• Modified version 835 Remittance Advice Retrieval
  The current system at Office of MaineCare Services does not offer 835 compliant transactions. In 2010, MaineCare's new claims system will offer 835 Remittance Advice forms.

Notice: At a separate website, you may subscribe to a Provider Notification Mailing List to receive by email the latest information.

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Information On:

EMC Frequently Asked Questions (FAQ)

EMC Downloads

Software Vendors

State of Maine website

Privacy Disclaimer (on State of Maine website)