From provider at lists.maine.gov Mon Feb 1 10:26:06 2010 From: provider at lists.maine.gov (Provider Notification) Date: Mon, 1 Feb 2010 10:26:06 -0500 Subject: [Provider] Time Correction - Phase II Nursing Home Training Message-ID: Attn: Nursing Home Facilities Please note the training times have changed. Please sign up for Phase II Nursing Home Training today!!! WHEN & WHERE: Tuesday, 2/2 at St. Mary's in Lewiston OR Tuesday, 2/9 at Maine Veteran's Hospital in Augusta. This is a full day training with the morning session running from 9:00-11:30 and the afternoon session running from 1:00-4:00. If you cannot attend in person, live meeting is available for both of these. WHY: This training will focus on the different aspects of billing in MIHMS as well as a review of the Rug methodology billing in the Emergency rule. To register or learn more, please call: 287-5336 or click here . -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20100201/1a6f751a/attachment.html From provider at lists.maine.gov Wed Feb 3 17:18:16 2010 From: provider at lists.maine.gov (Provider Notification) Date: Wed, 3 Feb 2010 17:18:16 -0500 Subject: [Provider] 2/3/10 Provider Listserv Message-ID: In this issue, you will find: 837 EDI Testing Now Fee Table Adjustments for DME Dealers Provider Training Updates Save the Date ? DHHS and APS Healthcare Conference 837 EDI Testing Now Available The MIHMS (Maine Integrated Health Management Solution) project is ready to begin certification testing of the EDI (Electronic Data Interchange) HIPAA compliant X12 837 transactions. Testing must be completed through the MyHealthPAS portal located at https://mainecare.maine.gov to be certified to submit electronic batch claims to production when MIHMS goes live for claims processing. To test EDI transactions, you must have either ?received a ?Welcome Letter? indicating that your re-enrollment application has been approved or ? registered as a billing agent trading partner for an approved provider. All providers must register as a trading partner in order to submit test claims. Software vendors cannot submit test claims to MIHMS production; however they can use the Ramp Management testing portal (located at the link below) to validate their EDI transactions. Certification testing is a self-service process. Trading partners (TP) will use the ?X12 Upload? link under ?File Exchange? on the Trading Partner tab to locate and upload X12 files to Health PAS OnLine for processing. This will allow TPs to browse their local computer or network to locate the appropriate file to be submitted. When a file is selected, the user will have to confirm that they have selected the appropriate file. The Usage Indicator, element 15 of the Interchange Control Header (ISA) of an X12 file must indicate a ?T? for a test file. Authorization will be granted on a per transaction basis. It is important to note, in order to process EDI transactions with MIHMS, this testing and file certification process must be completed for each transaction type that TPs want to process with the new system. For example, a trading partner may be certified to submit 837P professional claims, but not certified to submit 837I institutional claim files. Trading partners must successfully submit three (3) test files for each claim transaction type they intend to submit. Each test file must contain at least 15 transactions and 100% of the transactions must pass HIPAA validation. Testing for other HIPAA transactions such as the 270, 276 and 278 will be available at a later date. TPs will receive an e-mail notification when testing for each transaction has been successfully completed. This will also be indicated on the Trading Partner Status page. TPs are reminded of the availability of the Ramp Management secure pre-certification testing resource where they can submit test files at their convenience and receive real time validation of HIPAA levels 1-6. This site is located at https://sites.edifecs.com/?unisys and helps prepare TPs for EDI certification testing in MIHMS. To assist providers through the testing process, the EDI Help Desk staff is available from 8:00 am to 5:00 pm, Monday through Friday. Please do not hesitate to contact us by email at: mainecaresupport at unisys.com or by calling 866-690-5585. Thank you for your assistance in this process as we move closer to MIHMS implementation. Back to Top Attention DME Dealers: Fee Table Adjustments ? The Office of MaineCare Services has corrected the tax code internally and is reprocessing claims. You do not need to do anything. ? You will receive the adjusted rate on a future Remittance Advice. You will receive advance notice of when this is expected to happen. ? Regarding the annual Medicare Fee table, please remember that, as policy states, the Office of MaineCare Services will always pay the lowest of the rates; this includes Medicare. ? The Office of MaineCare Services will be scheduling a meeting in April 2010 for DME dealers. ? Going forward, MaineCare will only adjust rates on a quarterly basis. If you have any other concerns over DME rate codes, please bring them to the meeting in April. Back to Top Provider Training Updates Attention Nursing Home Facilities: Please note that the February 9th location in Augusta is at the Maine Veteran?s Home. (A previous communication stated that it was planned for the Veteran?s Hospital.) For more information or to register, please call 287-5336 or click here . Please note that all trainings currently scheduled will not be impacted by the change to the MIHMS implementation schedule. Additional training opportunities may be added to future dates. Back to Top Save the Date! Improving Health Outcomes with Integrated Physical and Behavioral Healthcare Conference A Conference co-sponsored by DHHS and APS Healthcare March 18, 2010 at the Augusta Civic Center Conference Goal: To promote increased integration of physical and behavioral healthcare in Maine. DHHS and APS Healthcare will accomplish this by providing education to the Maine provider community about current and planned DHHS policy/initiatives related to integration and examples of successful models of integration in the field. Featuring: ? Commissioner Brenda Harvey ? Ruth Katz, SAMSHA, Office of Disability, Aging, and Long?Term Care Policy ? Keynote Speaker ? Jerry Vaccaro, MD ? President of APS Healthcare ? A wide variety of breakout session speakers ? A plenary session with a panel of DHHS Office Leadership from the Commissioner?s Office, MaineCare, Child & Family Services, Adult MH Services and Substance Abuse discussing current and future state of DHHS integration initiatives/vision Registration materials will be available by 2/15/2010. Back to Top 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/20100203/4324e326/attachment.html From provider at lists.maine.gov Wed Feb 10 16:34:21 2010 From: provider at lists.maine.gov (Provider Notification) Date: Wed, 10 Feb 2010 16:34:21 -0500 Subject: [Provider] 2/10/10 MaineCare Listserv Message-ID: In this issue, you will find: Remittance Advice & Cost Settlements Mailing Schedule Communications Survey Remittance Advice & Cost Settlements Mailing Schedule This week's Remittance Advice Statements and Cost Settlements will be mailed separately. The RA will arrive on its usual schedule. You should receive the Cost Settlement report by Friday. Back to Top. Communications Survey We are looking for your feedback on the effectiveness and timeliness of communications you receive from MaineCare. Your input will be valuable to us as we strive to communicate efficiently and conveniently. This very brief multiple choice survey is anonymous unless you choose to provide your contact information. This survey should take less than five minutes to complete. To access the survey, click here . Back to Top. 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. Stay up to date on MaineCare's latest news and changes. Just visit OMS's list serve subscription page to get updates by e-mail! -------------- next part -------------- An HTML attachment was scrubbed... URL: http://mailman.informe.org/pipermail/provider/attachments/20100210/3212c5f1/attachment.html From provider at lists.maine.gov Thu Feb 18 16:02:13 2010 From: provider at lists.maine.gov (Provider Notification) Date: Thu, 18 Feb 2010 16:02:13 -0500 Subject: [Provider] 2/18/10 MaineCare Listserv Message-ID: In this issue, you will find: MIHMS Implementation Update HIPAA Electronic File Testing APS & DHHS Conference: Improving Health Outcomes with Integrated Physical and Behavioral Healthcare Communication Survey Update MIHMS Implementation Update Based on assessment of the work that has been done thus far, Commissioner Harvey, with the Steering Committee, has re-set the phase-in dates for the Maine Integrated Health Management Solution (MIHMS) project. ? On March 1, as previously scheduled, Unisys will assume operations for provider enrollment and maintenance. ? On July 1, prior authorization for billing in the MIHMS system will be in effect. ? On August 1, the MIHMS system will be fully functional. Adjusting the phase-in dates allows expansion of the rigorous testing process and time to make corrections that may come with additional testing. This will not impact the processing of your claims, which will continue with the current system. We believe that this change will put us in the best position to succeed when MIHMS is fully operational. Back to Top HIPAA Electronic File Testing If you intend to submit electronic files to MIHMS for claims, prior authorization, and/or eligibility, please read the following message: Providers with active Trading Partner Accounts can now begin testing the following HIPAA electronic requests through the Health PAS OnLine portal: ? 270 - Eligibility Benefit Inquiry ? 276 - Claim Status Request ? 278 - Prior Authorizations and Referrals Please note that these are in addition to the 837 transactions which are already available for testing. This testing is a self-service process. To begin the testing process, please visit https://mainecare.maine.gov and follow these steps: ? On the Trading Partner tab, select ?File Exchange? and use the ?X12 Upload? link to locate and upload X12 files to Health PAS OnLine for processing. ? This allows you to browse your local computer or network to locate the appropriate files to be submitted. ? Select the appropriate file to upload. ? Confirm the correct file is selected and submit the file. You must successfully submit three (3) test files for each claim transaction type you intend to submit. Each test file must contain at least 15 transactions and 100% of the transactions must pass HIPAA validation. You will receive an e-mail notification when testing for each transaction has been successfully completed. This will also be indicated on your Trading Partner status page. Companion Guides are available to help you prepare your electronic transactions to begin testing with MaineCare. The Companion Guides are found on the HealthPAS Online portal; please follow this link to access them: https://mainecare.maine.gov/Companion%20Guides/Forms/Publications%20View.aspx Also, help is on hand through the EDI Help Desk, Monday through Friday, from 8:00 am to 5:00 pm. The Help Desk staff can be reached by calling 866-690-5585 or by email at MainecareSupport at unisys.com. Back to Top Improving Health Outcomes with Integrated Physical and Behavioral Healthcare A conference co-sponsored by DHHS and APS Healthcare. This goal of this conference is to promote increased integration of physical and behavioral healthcare in Maine by highlighting current and planned DHHS policy / initiatives as well as successful integration models in practice. March 18, 2010 at the Augusta Civic Center 8:00am - 4:30pm Featuring: ? DHHS Commissioner Brenda Harvey ? Ruth Katz, SAMSHA, Office of Disability, Aging, and Long?Term Care Policy - Keynote Speaker ? Jerry Vaccaro, MD ? President of APS Healthcare ? Many other breakout session speakers Topics and breakout sessions include: ? A National Perspective on Integrated Physical and Behavioral Healthcare Policy ? A Vermont Solution to Improve Healthcare for Medicaid Beneficiaries ? Psychiatry Integrated Primary Care: ?Getting it Done? ? Uniting the Mind and Body: State and National Trends and Evidence-Based Practice in Integrated Care ? Psychiatrists Support Primary Care: Programs from the ME Association of Psychiatric Physicians ? The Maine Patient Centered Medical Home Pilot: An Opportunity to Promote Behavioral Health Integration in the Primary Care Community ? Primary Care Mental Health Integration: Key Components and Lessons Learned ? A Maine DHHS Perspective of Integrated Physical and Behavioral Healthcare ? AMHC?s Integrated Service Approach ? A DHHS Leadership Plenary Panel Discussion (with representation from the Commissioner?s Office, MaineCare, Child & Family Services, Adult MH Services and Substance Abuse) To register or learn more, please contact Kathy Scott at 1-866-521-0027 (select option ?0?) or: kscott at apshealthcare.com. Back to Top Communications Survey Thanks to all of you who took the time to complete our communications survey. The feedback has been thoughtful and informative. There is still time to take the survey if you have not yet done so! To access the survey, click here . Thanks! Back to Top 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/20100218/07d2b16a/attachment.html From provider at lists.maine.gov Fri Feb 26 13:19:00 2010 From: provider at lists.maine.gov (Provider Notification) Date: Fri, 26 Feb 2010 13:19:00 -0500 Subject: [Provider] 2/26/10 MaineCare Listserv Message-ID: In this message, you will find information on: * Physician Fee Increase * Provider Enrollment Update * Portal Outage Notice Physician Fee Increase An emergency rule is pending which will increase physician fees on March 1, 2010. The emergency rule for MaineCare Benefits Manual Section 90 Physician Services will be posted on the MaineCare website as soon as it is filed. MaineCare physician fees will be 70% of the 2009 Medicare rates, using the Maine area 99 schedule. The new fees apply only to non-hospital-based physicians, nurse practitioners, and Physician Assistants. A list of the codes and new fees is posted on MaineCare's website . The unit rates for anesthesia and radiology have also been increased; this will raise the amount paid to approximately 70% of Medicare. When the new claims system begins, MaineCare's payment for radiology and anesthesiology will be exactly 70% of Medicare's payment. MaineCare's current claims system can support only one physician fee schedule. MaineCare's new system, Maine Integrated Health Management Solution (MIHMS), will be able to support "facility-based" and "non-facility based" fee schedules. For all codes that have Medicare-published facility and non-facility based rates, MIHMS will refer to two fee schedules. With the new system, MaineCare will pay 70% of the Medicare facility-based fee when the procedure is performed in a hospital, skilled nursing facility, or ambulatory surgical center. Therefore, effective August 1, 2010 (MIHMS start date) there will be a second change to the fee table. The new system will also handle procedure codes with modifiers differently than the current system. In the new system, MaineCare will pay 70% of the modified Medicare rate. Because of the way the current system handles modifiers and place of service, it pays some claims more than 70% of Medicare rates. The new system will handle modifiers and place of service differently, and thus, may cause some payments to decrease. The start date for MaineCare's new claims system, MIHMS, is August 1, 2010. For questions about billing, please call MaineCare Customer Service at 1-800-321-5557 Option 8. Back to Top. Provider Enrollment As we continue to move forward with the MIHMS (Maine Integrated Health Management Solution) implementation, MaineCare will transfer Provider Enrollment operations to the Fiscal Agent (Unisys), effective March 1, 2010. Unisys will handle MIHMS-related provider file updates and enrollments. MaineCare Services staff will handle MeCMS-related updates. MaineCare and Unisys are committed to the provider re-enrollment effort and expect to finish this before MIHMS start date, August 1, 2010. MIHMS Enrollment If you have received your enrollment welcome letter, please "register" as a Trading Partner at MYHealthPAS portal at https://mainecare.maine.gov/. This will allow you to use Provider Maintenance. Here, you can add rendering providers to your file, update demographic information (such as address and phone number), and do other maintenance activities. MIHMS Provider Enrollment staff is available from 7:00 am to 6:00 pm, Monday through Friday. They can be reached by calling 866-690-5585 (TTY: 711), by fax: 877-314-8776 or by email at: MainecareEnroll at unisys.com for any questions or assistance with re-enrollment or provider maintenance. MeCMS Enrollment MIHMS and MeCMS will run concurrently for several months, so providers also need to keep their enrollment in MeCMS up-to-date. If you have MeCMS enrollment questions, please continue to use your MaineCare Provider Enrollment contact information. Back to Top. Portal Outage Please be advised that the Health PAS-Online portal will not be available from 7pm Friday Feb. 26, 2010 to 6am Monday March 1, 2010, due to a system upgrade. Back to Top. 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 MeCMS Provider Enrollment at 1-800-321-5557 Option #6. Effective March 1, 2010, MIHMS Provider Enrollment inquires can be directed to 1-866-690-5585. 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/20100226/eb8091cd/attachment.html