CORRECTION: Non-Billing, Ordering, Prescribing, and Referring (NOPR) Editing Changing from Warn to Deny – CR 121469

Dec 29, 2023

This message serves as a correction to information provided in our December 27th e-message regarding Non-Billing, Ordering, Prescribing, and Referring (NOPR) Edits. Point of Sale (POS) claims still require a NOPR but are NOT affected by this change. 

Effective January 1, 2024, claim edits will deny medical claims processed in MIHMS if the ordering, prescribing, or referring provider is not actively enrolled as a full MaineCare or NOPR provider. The claims will also be denied if the claim is submitted without the ordering, prescribing, or referring provider NPI.   

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