[Provider] Legacy Claim Adjustments (Pre-MeCMS Claims)

[Provider Notification]

ATTENTION:  All MaineCare Providers that submitted pinks or greens for
pre-MeCMS claims adjustment

 

The MaineCare Services' Claims Division has received authorization to
settle MaineCare Reimbursement Forms/Provider Additional Payment Request
Forms ("Pinks/Greens") that the Adjustment Unit currently has on file.
The Adjustment Unit will settle these by netting the overpayments
"pinks" and underpayments "greens" to arrive at an amount either owed
the provider, or owed MaineCare. These claims will not be adjusted in
MeCMS.

 

Each provider that we have forms on file for will be mailed a summary of
their MaineCare Reimbursement Forms/Provider Additional Payment Request
Forms on a spreadsheet beginning in July.  Providers due a net payment
by MaineCare will see the payment appear on their RA.  These payments
are identified with an invoice number beginning with LCYPAY followed by
a four digit number, i.e. LCYPAY0001. The MaineCare payment will be the
net of any amount the provider owes to any other state agency, i.e.,
Interim Payment Recovery.  

 

Maine hospital claims are reconciled in the cost settlement process, not
by claim adjustments.  These claims are not part of this special
processing.   (Please Note: the time limit has passed for filing
adjustments for underpayments on these claims.) 

 

Providers will receive begin to receive their spreadsheet summaries in
July.  Questions about the adjustment summaries  should be forwarded to
the provider's Medical Support Specialist (Claims Adjuster).  The link
to the roster of Claims Adjusters is here:
http://www.maine.gov/dhhs/oms/pdfs_doc/provider/medical_support_speciali
sts052609.pdf   

 

For general questions about billing, please feel free to contact the
Billing & Information line at 1-800-321-5557 Option #8.  

 

 

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
<http://www.maine.gov/dhhs/bms/member/innerthird/listserv.shtml>  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.

 

 

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