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MaineCare Enrollment and Billing Training and Technical Assistance Sessions

The Maine Department of Health and Human Services, Office of MaineCare Provider Relations and the Maine Department of Education are offering a series of training and technical assistance sessions throughout the state in the coming weeks to help school districts and special purpose private schools address any questions or issues that they may have relative to enrollment and  billing MaineCare for services.

The intended audience is Superintendents, Special Education Directors, Special Education Secretaries or anyone involved in providing information for billing of MaineCare services. Billing agencies are not invited to these sessions; they will receive specialized services on another date.

The sessions will be held in Maine Department of Health and Human Services offices in the following communities on the following dates from 9 a.m. to 4 p.m.

PLEASE NOTE: THE BANGOR SITE HAS HAD A CORRECTION IN THE ADDRESS: Dorothy Dix Psychiatric Center, DHHS 656 State Street, Bangor, ME.

  • May  10, Caribou, 30 Skyway Drive
  • May  12, Bangor, 396 Griffin Road
  • May  17, Ellsworth, 17 Eastward Lane
  • May  24, Portland, 161 Marginal Way
  • June 2, Augusta, 442 Civic Center Drive
  • June 6, Augusta, 442 Civic Center Drive
  • June 8, Biddeford, 208 Graham Street

 

 Sign up for a training session

 

Agenda

 

AM Session:     9:00 AM-12:00 PM

Welcome and Introductions                                                                                       

Enrollment Process and Maintenance Case Updates

  • Enrollment Checklist

Determining Medical Eligibility

  • Medical Necessity Decision Tree

Behavioral Health Professionals

  • Clarification of Certification

Prior Authorization Process

Documentation of Services

  • Record Retention
  • IEP/ITP

“Pay and Chase” Methodology

Contacts:

  • Who to Call

PM Session:                 1:00 PM – 4:00 PM

MaineCare Site Demo

  • Where To find Policy- Proposed and Adopted
  • Provider Relations Specialist Map of Counties

Claim Submission Demo

  • Paper Claims
  • Direct Data Entry in the Portal

Definitions of Denials

  • Link for Common Adjustments and Denial Reasons

Individual Work Sessions – As Needed