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<p class=MsoNormal><b><font size=4 face=Arial><span style='font-size:14.0pt;
font-family:Arial;font-weight:bold'>ATTENTION: MaineCare Substance Abuse
Agency Providers<o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>MaineCare is making changes to billing for services provided
by Certified Alcohol and Drug Counselors (CADC’s) employed by Substance
Abuse Agencies. As part of these changes, MaineCare will require
providers to enroll all CADC’s as servicing providers. A servicing
provider enrollment form is attached for this purpose.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>MaineCare already requires agencies to enroll all Licensed
Alcohol and Drug Counselors (LADC’s) as servicing providers. If a
Substance Abuse Agency has any LADC’s who are not enrolled as servicing
providers, forms should be completed for those servicing providers at this
time.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>The completed form and copy of the CADC license should be
sent to:<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>Provider Enrollment<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>MaineCare Services<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>442 Civic Center Drive<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>#11 State House Station<o:p></o:p></span></font></p>
<p class=MsoNormal><st1:place w:st="on"><st1:City w:st="on"><font size=3
face=Arial><span style='font-size:12.0pt;font-family:Arial'>Augusta</span></font></st1:City><font
face=Arial><span style='font-family:Arial'>, <st1:State w:st="on">Maine</st1:State>
<st1:PostalCode w:st="on">04333</st1:PostalCode></span></font></st1:place><font
face=Arial><span style='font-family:Arial'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'>These forms must be returned and the
servicing provider associated with the agency billing number prior to billing
for services provided on or after August 1. </span></font></b><font face=Arial><span
style='font-family:Arial'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>Agency providers will also need to have the CADC servicing
provider number to include on their claim form when billing for services
provided by the CADC.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>Please contact MaineCare Customer Service at 1-800-321-5557,
Option 6 if you have any questions on enrolling servicing providers.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><i><font size=1 face=Arial><span style='font-size:9.0pt;
font-family:Arial;font-style:italic'>This is a one-way communication. Please
do not respond to this message.<o:p></o:p></span></font></i></p>
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