[Provider] Update: Billing with Prior Authorization Under the Behavorial Health ASO (Administrative Services Organization)

[Provider Notification]

ATTENTION:  All MaineCare Providers planning to submit claims under the
Behavioral Health ASO

When submitting an Initial Registration or Prior Authorization Review
with APS Healthcare (the behavioral health ASO), Prior Authorizations
should be set up with a 01/01/08 effective date as the start date for
both time and number of services.

If a claim includes a PA number and the service billed is not flagged in
MeCMS to require a PA during the dates of service billed, it is possible
the claim will suspend. Therefore, providers are advised to not enter a
PA number on a claim if the service they are billing does not require a
Prior Authorization for the dates of service billed. Specifically, any
APS Healthcare-generated PA numbers should only be entered on claims
that bill dates of service on or after 1/1/2008.

This is a one-way communication.  Please do not respond to this message.

 

 

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