[Provider] Nursing Facility Cost of Care Adjustments

[Provider Notification]

ATTENTION:  All MaineCare Nursing Facility Providers

 

On November 17, 2008 MaineCare deployed a patch to MeCMS to correct the
problem of Cost of Care amounts not being properly assessed on type 12
(Nursing Home) claims.  This patch corrected the faulty edit logic, and
Cost of Care is now being processed correctly for both PNMI and Nursing
Facility claims.

 

16,700 type 12 claims have been identified, which were processed without
applying cost of care.  MaineCare processed these claims between October
14th and November 17th 2008.  These claims will now be re-processed
beginning February 23rd, 2009.

 

These claims will be manually re-processed as adjustments. Providers
will see the cost of care taken out that was not taken out on the
original claim.  The Remittance Advice (RA) will reflect an adjustment
with an adjustment source of "State Initiated".

 

MaineCare will not manually re-process any claims that have already been
submitted for adjustment by the provider. 

 

 

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

 

 

 

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