From provider at lists.maine.gov Wed Aug 5 10:40:30 2009 From: provider at lists.maine.gov (Provider Notification) Date: Wed, 5 Aug 2009 10:40:30 -0400 Subject: [Provider] MaineCare Provider message for Targeted Case Management / APS Member Re-enrollment Message-ID: ATTENTION: Providers of TCM and PNMI Appendix 97 Services Affected by the Recently Released New Rules We understand that many of you are very concerned about the need to re-register members with APS Healthcare due to these emergency rule changes and we appreciate those concerns. APS Healthcare is committed to working diligently with the provider community to make sure you have the assistance needed to complete this re-registration process, have new authorization/billing numbers issued and receive "in the moment" assistance through their provider relations call center. Providers needing specialized assistance should contact Kelly Bickmore, Operations Director, APS Healthcare at 866-521-0027. Additionally, MaineCare Services will not be editing claims to require the new authorization numbers until September 1, 2009. This is to allow time for providers to complete the re-registration process by the end of August. As we look to the future and finalizing design for the new Medicaid claims processing system, known as Maine Integrated Health Management Solution (MIHMS), we are analyzing ways to solve this issue so that impact to providers by these types of policy changes are minimized. We are also in the process of analyzing system conversion alternatives that will minimize the necessity to re-register members to the extent possible. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's Listserv Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090805/e7bd651e/attachment.html From provider at lists.maine.gov Wed Aug 5 13:32:57 2009 From: provider at lists.maine.gov (Provider Notification) Date: Wed, 5 Aug 2009 13:32:57 -0400 Subject: [Provider] Clarification for Targeted Case Management / APS Member Re-enrollment Message-ID: ATTENTION: Providers of PNMI Appendix 97 Services Affected by the Recently Released New Rules A recent listserv message focused on provider concerns regarding the need to re-register members with APS Healthcare due to emergency rule changes. Please accept this clarification that the information pertains to (in addition to Targeted Case Management), PNMI, Appendix D services. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's Listserv Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090805/9fa7311f/attachment.html From provider at lists.maine.gov Wed Aug 5 13:51:55 2009 From: provider at lists.maine.gov (Provider Notification) Date: Wed, 5 Aug 2009 13:51:55 -0400 Subject: [Provider] Notice from APS to all APS-Maine ASO Providers Message-ID: ATTENTION: All MaineCare Providers working with the APS Administrative Services Organization New MaineCare Emergency Rules are now posted on the DHHS site at this link: http://www.maine.gov/dhhs/oms/rules/emergency.html These new rules include new procedure codes. These new procedure codes require some services to be re-registered with APS Healthcare. 1. The Revised APS Healthcare Maine Behavioral Health ASO Service Grid is posted at this link: http://www.qualitycareforme.com/documents/provider_providermanual_servic egrid.pdf 2. Targeted Case Management re-registration instructions are posted at this link: http://www.qualitycareforme.com/documents/TCM_Service_Grid_Changes_Re-Re g_Inst.pdf 3. The Treatment Foster Care Level of Care Assessment process with APS Healthcare is effective 8/1/09. Instructions for this process and re-registration instructions are posted at this link: http://www.qualitycareforme.com/documents/Tx_Foster_Care_LOC_Assess_APS- Prov_inst.pdf 4. Child PNMI Re-registration instructions are posted at this link: http://www.qualitycareforme.com/documents/Child_PNMI_Service_Grid_Change s_Re-Reg_Inst.pdf What does this mean for Providers? Providers of these services must re-register them with APS Healthcare, due to the new procedure codes. Treatment Foster Care providers will now conduct level of care assessments with APS Healthcare, instead of with DHHS staff. What does this mean for MaineCare Members? Members should contact their provider for further information about whether their particular services are effected by any of these changes. Members can also call the APS Healthcare Member Services Liaison (Simonne Maline) at 1-866-521-0027 Option 3 if they have questions about these changes. The APS-Maine website is located at: www.qualitycareforme.com Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's Listserv Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090805/8973e78c/attachment.html From provider at lists.maine.gov Thu Aug 6 15:18:30 2009 From: provider at lists.maine.gov (Provider Notification) Date: Thu, 6 Aug 2009 15:18:30 -0400 Subject: [Provider] Excluded Providers - now available online Message-ID: MaineCare providers are prohibited from employing people who have been excluded by Maine or by the federal government. MaineCare and/or Medicare exclude people and companies who have been convicted of certain types of crimes or have been disciplined by their professional board for licensing violations. MaineCare's website now has a list of people who have been excluded by the state. The Maine Excluded Providers Database is searchable by the person or company's name. Users can then verify the Social Security or Employer Identification Number. Also available on-line are FAQs on Excluded Providers . To check whether a person is excluded by the federal government, providers can use the Office of Inspector General Excluded Providers Database . Providers should check both the state and federal websites to confirm whether a person has been excluded. Maine may have excluded someone that is not excluded by the federal government. And the federal government may have excluded someone not listed on Maine's website. Feel free to contact the Program Integrity Unit at 207-287-4660 with questions. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090806/aa8aa56f/attachment.html From provider at lists.maine.gov Thu Aug 13 09:49:19 2009 From: provider at lists.maine.gov (Provider Notification) Date: Thu, 13 Aug 2009 09:49:19 -0400 Subject: [Provider] Conference call 9/15/09 re - NDC Code reporting for hospital outpatient services Message-ID: Attention: All Hospital Providers On Thursday, September 15th from 10:00 to 11:00, MaineCare will host a follow up roundtable discussion on National Drug Codes for hospital outpatient services. Topics will include * Expected changes in 2010; * The state legislature's goal to collect more drug rebates; and, * How NDC codes will be handled in the new system, MIHMS. The conference number is 1-800-394-6604, and participant code is 934057. There is no need to RSVP to join the call. Contact Cheryl Rood with questions. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090813/f01df53f/attachment.html From provider at lists.maine.gov Thu Aug 13 14:09:21 2009 From: provider at lists.maine.gov (Provider Notification) Date: Thu, 13 Aug 2009 14:09:21 -0400 Subject: [Provider] Incontinent supplies formulary update Message-ID: The MaineCare Incontinent Supplies Formulary has been updated on line. Pack counts and size and weight on a few codes were corrected. Also, MaineCare will begin using a new code for incontinent wipes: S5199. Please start using the new code as of August 1, 2009. The specific changes were: T4532 ISG30FTP4 corrected pack count to qty 13 T4532 KND70074 corrected pack count to qty 14 T4532 ISG30FTP3 corrected pack count to qty 15 T4534 KND70075 corrected size & weight to XLg/80-125lbs T4537 ISG13436 corrected T-code to T4537 T4535/S5199 updated Reimbursement code to S5199/added SCA wipe SCT64610 and deleted AMD wipe If you have billing questions, please call MaineCare's Billing & Information Line at 1-800-321-5557 Option #8. If you have questions about the incontinent supplies formulary, please contact Jennifer Cook at MaineCare. Thank you for serving MaineCare members. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090813/7de428a9/attachment.html From provider at lists.maine.gov Fri Aug 14 09:10:16 2009 From: provider at lists.maine.gov (Provider Notification) Date: Fri, 14 Aug 2009 09:10:16 -0400 Subject: [Provider] Adopted rules - Targeted Case Management, Community Support, Private Non-Medical Institutions, Home Health Message-ID: This message is to give notice that rules listed below were recently adopted. Adopted rules are final and no changes can be made at this point. MaineCare Benefits Manual Section 13 Targeted Case Management MaineCare Benefits Manual, Chapter III, Section 17, Community Support Services MaineCare Benefits Manual, Chapter II, Section 97, Private Non-Medical Institutions MaineCare Benefits Manual, Chapter III, Section 97, and Appendix D and E, Private Non-Medical Institutions MaineCare Benefits Manual, Chapter II and III, Section 40, Home Health Services MaineCare Benefits Manual, Chapters II & III, Section 13, Targeted Case Management Concise Summary: The Department is repealing and replacing Targeted Case Management rules in this Emergency rulemaking. Services in the former rule will no longer be available upon implementation of these rules. Target groups have been consolidated and redefined. Several target groups are being deleted, including Pregnant and Postpartum women, Adults with Diabetes and Asthma and Members who are receiving Healthy Futures Services. The Department is adding language detailing eligibility criteria for Children and Adults to include Case Management Services for Children with Developmental Disabilities and Behavioral Health Disorders as well as Case Management Services for Adults with Developmental Disabilities, Behavioral Health Disorders, Substance Abuse Disorders, HIV, Long Term Care Needs and Members Experiencing Homelessness. Children's targeted case management services require prior authorization, . This rule also reduces funding for children's targeted case management by limiting services to two (2) months for children with scores between fifty (50) and seventy (70) on the Child and Adolescent Functional Assessment Scale. The assessment tool score may not be the sole criterion for determining medical necessity, needs and/or eligibility. This rulemaking contains changes to the TCM service and delivery required by federal Medicaid regulation. 42 C.F.R. ? ? 440.169 and 441.18. For example, this rule clarifies that MaineCare will not cover multiple case management services; and sets forth the eligibility process, and the requirement of transitioning to one comprehensive case manager for children and adult members. Chapter III establishes new billing procedure codes based on HIPAA compliant HCPCS coding. Chapter III also implements a change in reimbursement to some Providers/Case Management Agencies through the requirement of billing in fifteen (15) minute increments. Record-keeping requirements for TCM providers have been added to the rule. On June 1, 2009, the Department mailed a notice to TCM recipients notifying them of changes to the TCM service. On June 31, 2009, the Department published a Notice of Change in Medicaid Reimbursement Methodology to notify TCM providers of rate changes. The Department anticipates achieving a cost savings in the General Fund of $ 4,138,665 per State fiscal year 2010/2011. The Department expects an annual decrease in annual aggregate (state and federal) expenditures of $11,744,223.00 per State fiscal year 2010/2011. Other than providers of these specific services, This rule is not expected to fiscally impact or create new recording burdens for other small businesses and is not expected to yield new costs for municipal or county governments. Effective Date: August 1, 2009 Agency Contact Person: Melanie Miller, Health Planner Agency Name: Division of Policy and Performance Address: 11 State House Station Augusta, Maine 04333-0011 Telephone: (207)-287-4459 FAX: (207) 287-9369 TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing) MaineCare Benefits Manual, Chapter III, Section 17, Community Support Services Concise Summary: The Emergency rule specifies a correction in the rate for Day Treatment. Effective Date: 7/1/09 Agency Contact Person: Ginger Roberts-Scott, Comprehensive Health Planner Agency Name: Division of Policy and Performance Services Address: 11 State House Station Augusta, Maine 04333-0011 Telephone: (207)-287-9365 FAX: (207) 287-9369 TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing) ______________________________________________________________________________ MaineCare Benefits Manual, Chapter II, Section 97, Private Non-Medical Institutions Concise Summary: The Department has determined that the immediate adoption of these rules is necessary to assure targeted budget savings are met. In this rulemaking, the Department is adding language detailing eligibility criteria and requiring prior authorization for children's PNMI services. These changes are necessary to assure that PNMI services are medically necessary and that more cost effective community based services are used to the fullest extent possible. In this Section, the Department is also defining models of PNMI services for which standard rates are being set in a separate rulemaking pertaining to reimbursement of PNMI services in Chapter III, Section 97. These rules will remain in effect for 90 days while the Department permanently adopts these changes in a proposed rulemaking. A public hearing will be held as part of that separate rulemaking. This rule has no impact on small businesses, counties or municipalities, other than those providers with twenty or fewer employees. These rule changes are expected to result in total savings of $8,538,368. The changes for children's PNMI services will result in cost savings per State Fiscal year of $6,838,368, $2,091,857 from general funds, $4,404,593 from federal funds and $341,819 from other special revenue. The changes for adult PNMI services are expected to result in an additional $1.7 million savings per State Fiscal year, $1,615,000 from general funds and $85,000 from other special revenue. Effective Date: August 1, 2009 Agency Contact Person: Patricia Dushuttle Agency Name: Office of MaineCare Services Address: 11 State House Station Augusta, Maine 04333-0011 Telephone: (207)-287-9368 FAX: (207) 287-9369 TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing) MaineCare Benefits Manual, Chapter III, Section 97, and Appendix D and E, Private Non-Medical Institutions Concise Summary: The Department has determined that the immediate adoption of these rules is necessary to assure that initiatives directed by the Maine State Legislature are immediately implemented to achieve required savings in the approved budget. The Legislature, in Public Law chapter 213, authorizes emergency rulemaking on or before 12/31/09 for provisions over which the Department has subject matter jurisdiction without demonstrating that emergency rule implementation of this rule is necessary to avoid a threat to public health, safety or general welfare. These emergency rules specifically address budget initiatives for children's Private Non-Medical Institution (PNMI) services and for adults with mental illness. In this rulemaking, the Department is setting standard rates for children's PNMI services and is removing language about cost settlement for facilities reimbursed under Appendix D, as the Department will no longer cost settle these services. The Department has also made changes to Appendix E, Community Residences for Persons with Mental Illness to clarify that "scattered site" services are no longer reimbursed under this Section. Those services will still be provided to members in their apartments, but instead will be reimbursed through Community Support Services under Section 17 of the MaineCare Benefits Manual. The Department has sent a notice to those affected members to inform them of this change in services. Prior authorization will be required for all behavioral health PNMI services for children and adults to assure that required savings are met and that services are medically necessary. All child care providers will need to bill new codes for reimbursement. The Maine State Legislature has directed the Department to achieve $6.5 million savings per State fiscal year in this rulemaking for children's services. Another $ 1.6 million of savings is expected through the scattered site housing changes. Because these rules are major substantive, the emergency rules will remain in effect for one year or until the legislature approves them. The Department will propose rules through the regular Administrative Procedures Act (APA) process to provisionally adopt these rules. A public hearing will be held as part of that process. Agency Contact Person: Patricia Dushuttle Agency Name: Office of MaineCare Services Address: 11 State House Station Augusta, Maine 04333-0011 Effective Date: August 1, 2009 MaineCare Benefits Manual, Chapter II and III, Section 40, Home Health Services Concise Summary: The Department proposes changes to the above named section of policy. Specifically, in Chapter II, the Department is proposing to change ?40.05-E, Medical Supplies, which will eliminate routine supplies as a separately coverable service. The costs associated with these supplies will be included in the service rates listed in Chapter III. Furthermore, this section also clarifies language for non-routine supplies to state that these supplies are not billable under section 40 and must be billed under section 60. In addition, the Department is simultaneously proposing Chapter III and proposes new HIPAA compliant codes for the reimbursable services under this section. These coding changes are required in order to comply with Federal statute. All changes must be approved by the legislature as these are major substantive rules and are planned to go in effect upon implementation of MIHMS. Deadline For Comments: Comments must be received by midnight August 15, 2009. Agency Contact Person: Alyssa Morrison, Health Planner Agency Name: Office of MaineCare Services Address: 11 State House Station Augusta, Maine 04333-0011 Telephone: 207-287-9368 FAX: (207) 287-9369 TTY: 1-800-423-4331 or 207-287-1828 (Deaf or Hard of Hearing) The Division of Policy posts all proposed and recently adopted rules on MaineCare's website. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefit Manual is available on-line at the Secretary of State's website . Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090814/0bc8860d/attachment.html From provider at lists.maine.gov Fri Aug 14 09:15:15 2009 From: provider at lists.maine.gov (Provider Notification) Date: Fri, 14 Aug 2009 09:15:15 -0400 Subject: [Provider] Proposed Rules: Estate Recovery, Home Health Message-ID: This notice is to announce proposed rules for the sections listed below. Proposed rules are issued to the public for review and comment. These rules may change before finally adopted. NOTE: Home Health rules were included in an earlier list serve message as adopted rules. The home health rules have not yet been adopted, and are still accepting public comments. MaineCare Benefits Manual, Chapter VII section 5, Estate Recovery MaineCare Benefits Manual, Chapter II and III, Section 40, Home Health Services MaineCare Benefits Manual, Chapter VII section 5, Estate Recovery Concise Summary: The Department of Health and Human Services is proposing changes to the MaineCare Benefits Manual, Chapter VII, Section 5, Estate Recovery. This proposed rule makes four specific changes to the Estate Recovery program. The rule adds an exemption reflecting the value of benefits paid under a qualified long term care insurance policy. Amounts exempted from recovery due to qualified LTC insurance policies are expected to be significantly offset by overall MaineCare savings resulting due to more long term care services being paid through private insurance. This rule also limits the availability of the Care Given Exemption to persons whose incomes are less than or equal to 200 percent of the federal poverty level, as mandated by the federal Centers for Medicare and Medicaid Services. Under the new "care given exemption" language, the Department has far less authority to waive recovery from certain estate assets than it could under the pre-existing rules. The proposed rule also includes two policy changes mandated by the Legislature, barring estate recovery from members' joint tenancy interests in real property and striking language relating to delayed recovery from the estates of certain survivors. The Department also made other structural, administrative, grammatical and clarifying within this rulemaking. Public Hearing: August 26, 2009 9 AM Conference Room # 4 Department of Health and Human Services Office of MaineCare Services 442 Civic Center Drive Augusta, ME Deadline For Comments: Comments must be received by midnight September 7, 2009 Agency Contact Person: Nicole Rooney, Comprehensive Health Planner Agency Name: Office of MaineCare Services Address: 11 State House Station Augusta, Maine 04333-0011 Telephone: 207-287-4460 FAX: (207) 287-9369 TTY: 1-800-423-4331 or 207-287-1828 (Deaf or Hard of Hearing) MaineCare Benefits Manual, Chapter II and III, Section 40, Home Health Services Concise Summary: The Department proposes changes to the above named section of policy. Specifically, in Chapter II, the Department is proposing to change ?40.05-E, Medical Supplies, which will eliminate routine supplies as a separately coverable service. The costs associated with these supplies will be included in the service rates listed in Chapter III. Furthermore, this section also clarifies language for non-routine supplies to state that these supplies are not billable under section 40 and must be billed under section 60. In addition, the Department is simultaneously proposing Chapter III and proposes new HIPAA compliant codes for the reimbursable services under this section. These coding changes are required in order to comply with Federal statute. All changes must be approved by the legislature as these are major substantive rules and are planned to go in effect upon implementation of MIHMS. Deadline For Comments: Comments must be received by midnight August 15, 2009. Agency Contact Person: Alyssa Morrison, Health Planner Agency Name: Office of MaineCare Services Address: 11 State House Station Augusta, Maine 04333-0011 Telephone: 207-287-9368 FAX: (207) 287-9369 TTY: 1-800-423-4331 or 207-287-1828 (Deaf or Hard of Hearing) The Division of Policy posts all proposed and recently adopted rules on MaineCare's website. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefit Manual is available on-line at the Secretary of State's website . Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090814/87c87df8/attachment.html From provider at lists.maine.gov Fri Aug 14 16:26:49 2009 From: provider at lists.maine.gov (Provider Notification) Date: Fri, 14 Aug 2009 16:26:49 -0400 Subject: [Provider] TCM - certain changes are delayed Message-ID: Due to unforeseen complexities, some of the provider billing changes announced in recent rule-making by MaineCare for Targeted Case Management will be delayed. Changes in billing will not take place for case management services for * Adult members with developmental disabilities, * members with HIV or * members receiving Long Term Care Case Management with Alpha One and Elder Independence of Maine. Providers of these services should continue to bill as they have in the past. Other billing changes and re-registration with APS required under the Emergency Rule will go into effect as planned. These changes affect * all children's case management services, including behavioral health, developmental disabilities and chronic medical care; and, * services provided to homeless adults and children. Please also note that a mistake in the rule-making will be corrected for HIV case management services. Services provided to this group will be billed weekly, not monthly. There will also be a correction regarding eligibility criteria for members experiencing homelessness. The corrected criteria will not require that the member reside in a homeless shelter either currently or in the past 90 days. New emergency rule-making for Targeted Case Management will be issued soon. The Division of Policy posts all proposed and recently adopted rules on MaineCare's website. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefit Manual is available on-line at the Secretary of State's website . Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090814/e6d655d4/attachment.html From provider at lists.maine.gov Mon Aug 17 15:28:51 2009 From: provider at lists.maine.gov (Provider Notification) Date: Mon, 17 Aug 2009 15:28:51 -0400 Subject: [Provider] MeCMS Update for Case Management Limits Message-ID: Attention: MaineCare Providers of Targeted Case Management Services Some claims for procedure codes Z9422 and Z9423 were being denied for "case management limit exceeded". This limit has since been updated in MeCMS. Providers should submit a re-bill for their denied claims. Please contact your MaineCare Provider Relations Specialist at 800-321-5557, option 8 with any questions. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's Listserv Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090817/2860de34/attachment.html From provider at lists.maine.gov Tue Aug 18 14:11:31 2009 From: provider at lists.maine.gov (Provider Notification) Date: Tue, 18 Aug 2009 14:11:31 -0400 Subject: [Provider] Correction: conference call re - hospital outpatient NDC codes Message-ID: Attention: All Hospital Providers The roundtable discussion on National Drug Codes for hospital outpatient services will be held Tuesday, September 15th from 10:00 to 11:00a.m. (An earlier list serve message misstated the day of the call.) The conference number is 1-800-394-6604, and participant code is 934057. There is no need to RSVP to join the call. Contact Cheryl Rood with questions. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's List Serve Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090818/b565247a/attachment.html From provider at lists.maine.gov Thu Aug 20 13:08:21 2009 From: provider at lists.maine.gov (Provider Notification) Date: Thu, 20 Aug 2009 13:08:21 -0400 Subject: [Provider] Provider Portal for MIHMS Re-enrollment Now Open Message-ID: ATTENTION: All MaineCare Providers MaineCare Re-enrollment for MIHMS is now Open for Cycle 1 Providers The MIHMS provider portal is now open for Cycle 1 of provider re-enrollment. A re-enrollment notice is being mailed to all current MaineCare providers. This letter can be found on the MaineCare web site at http://www.maine.gov/dhhs/oms/member/innerthird/fa_mihms_reenroll.html under the headline "Re-enrollment Portal Now Available". The URL for the MIHMS provider portal, where re-enrollment takes place is https://mainecare.maine.gov (The web address for the portal is misstated in the first set of Cycle 1 provider letters, but has been corrected in the letter posted on the web site.) The schedule for re-enrollment is: Cycle 1: Now through September 16 Cycle 2: September 17 through October 14 Cycle 3: October 15 through November 13 Providers should not attempt to re-enroll prior to their assigned dates. The re-enrollment application is being updated to reflect policy revisions and attempting to re-enroll early will result in an inability to complete the re-enrollment application. The assignment of provider organizations to re-enrollment cycles can be found on the MaineCare web site at http://www.maine.gov/dhhs/oms/member/innerthird/fa_mihms_reenroll.html within the "Provider Re-enrollment Information" box. Questions regarding re-enrollment can be sent to MaineCare2010.DHHS at maine.gov Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's Listserv Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090820/b5fc0721/attachment.html From provider at lists.maine.gov Fri Aug 21 16:21:57 2009 From: provider at lists.maine.gov (Provider Notification) Date: Fri, 21 Aug 2009 16:21:57 -0400 Subject: [Provider] TCM Providers: clarification about rebilling Message-ID: Attention: MaineCare Providers of Targeted Case Management Services An earlier list serve message advised TCM providers to re-bill claims for procedure codes Z9422 and Z9423 that were denied for "case management limit exceeded". Some of these denials are proper, such as when two case management providers have billed for the same date of service. Therefore, not all claims denied for "limit exceeded" should be re-billed. Providers should re-bill claims with dates of service after 8/31/2008 that have denial code #119. This denial code was recently corrected. Claims with this denial code may have been improperly denied. Please contact your MaineCare Provider Relations Specialist at 800-321-5557, option 8 with any questions. Is your mailing address up to date with MaineCare? Please keep MaineCare up to date so your Remittance Statements and checks arrive on time. Call Provider Enrollment at 1-800-321-5557 Option #6. If you would rather not get these e-mails, visit MaineCare's Listserv Subscription page to unsubscribe. This is a one-way communication. Do not reply to this e-mail. Your e-mail will not receive response. If you have questions, please call 1-800-321-5557. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20090821/cbd45f87/attachment.html