[Provider] Repaying the Department

[Provider Notification]

ATTENTION: MaineCare Providers who need to return money to the
Department

 

To clarify how to repay money to the Department, MaineCare offers the
summary below.  

 

Interim Payments 

The Department expects full repayment of all outstanding interim
balances. 

*	Providers can 

	*	submit checks, 
	*	offset paid claims or 
	*	apply outstanding cost settlements.

*	The Department will work with you to repay balances using any of
the above methods.

 

Claims Adjustments

Providers may owe the Department money related to overpaid claims.  You
can repay the Department by submitting claim adjustments.  

*	If you are currently submitting claims and receiving payments,
the system will automatically recapture the money owed to the
Department. 
*	Please do not submit checks along with the claims to be adjusted
(known by many providers as "pinks").  

	*	If you do submit a check with the "pink" adjusted
claims, the adjustment unit will make every effort to process the
adjustments and remove the automatic offset.  
	*	If staff is able to remove the automatic offset for your
adjustment, you will not see the payment and the adjustment on your
Remittance Advice (RA).  This data will appear on your RA when that
function is added to the system.  

 

Claim Voids

Providers can submit a void to a claim that was overpaid through the
system and MeCMS will recapture the overpayment from current paid
claims.

 

If you cannot void claims in the system, i.e., you no longer bill
MaineCare, or if the number of voids you need to process would cause a
severe cash flow issue, you can submit a check.  

*	Before you submit a check, please contact the Adjustment Unit.  
*	The Adjustment Unit will then process the voids as "non-offset"
voids.  These show up on the RA with an "N" in the offset column.  A
"non-offset" receivable -- a receivable that WILL NOT recoup money from
current claims -- is created in the amount of the voided claims. 
*	The non-offset receivable will appear on your RA in the far
right section of the summary page. After the receivable shows up on the
RA, the Adjustment Unit will apply your check to the receivable. 
*	After the check is applied, your RA will show the amount owed
and the amount applied, leaving a zero balance. 

 

Questions about repaying money? Call Customer Service at 1-800-321-5557
Option #8.  If you need the Adjustments Unit staff to help you with a
specific problem, please refer to the attached staff directory.  

 

Stay up to date on MaineCare's latest news and changes.  Just visit 
OMS's list serve subscription page
<http://www.maine.gov/dhhs/bms/member/innerthird/listserv.shtml>  to get
updates by e-mail!

 

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