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Online Help Help

  • MaineCare Health PAS Online Portal
    Serving the MaineCare population to improve health care outcomes
    MaineCare, which is a state and federally funded Program, provides healthcare coverage for eligible individuals and families.
  • MaineCare Health PAS Online Portal
    Serving the MaineCare population to improve health care outcomes
    MaineCare, which is a state and federally funded Program, provides healthcare coverage for eligible individuals and families.
  • MaineCare Health PAS Online Portal
    Serving the MaineCare population to improve health care outcomes
    MaineCare, which is a state and federally funded Program, provides healthcare coverage for eligible individuals and families.
    
1/18/2017 3:13 PM

Welcome to the updated MaineCare Health PAS Online Portal! Please take a few moments to familiarize yourself to our new look and to review the public information and forms that are currently available to you. If you are registered as a trading partner, you can now sign in to the secure portion of the portal and all functionalities are available to you. If you are not currently a trading partner, you can register by clicking on the link in the upper right hand corner. Please contact Provider Services with questions at: 1-866-690-5585, option 2; TTY users dial 711.  

Welcome to the Health PAS Online Portal for MaineCare members and service providers!

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MaineCare is healthcare coverage for eligible individuals and families. This program is funded by state and federal dollars.

This website provides information to MaineCare members, providers, trading partners, and the public.
Website Maintenance
2/3/2017 7:50 PM
Health PAS Browser Compatibilty
2/3/2017 7:50 PM

 Member

Login to the Member Secure Portal to view or request your:
  • Letter of Creditable Coverage
  • Claims History Report

 Providers / Trading Partners

Login to the Provider Secure Portal to:
  • View MaineCare eligibility and history
  • Submit claims
  • Submit referrals, authorizations or certification requests
  • Check submission status
  • Perform Provider Enrollment / Maintenance Functions
1/23/2017 1:58 PM

Update to 2016 McKesson InterQual Criteria Sheets: Bone Growth Stimulators 

Effective January 17, 2017, the 2016 McKesson InterQual Criteria Sheets for Bone Growth Stimulators have been updated on the Health PAS Online Portal and will be used as guidelines to approve or deny Prior Authorization (PA) requests. If the nurse reviewer needs additional information to decide the request based upon the new criteria sheet, the PA request will be deferred for more info. 

Old McKesson InterQual Criteria Sheets 

On or after February 17, 2017, you must submit the appropriate 2016 McKesson InterQual Bone Growth Stimulator Criteria Sheet along with your PA request. If you submit the old version of the McKesson InterQual criteria sheet, your PA request will be deferred and you will receive a letter requesting the 2016 version. 

Accessing the 2016 McKesson InterQual Criteria Sheets 

The 2016 McKesson InterQual Criteria Sheets can be accessed by logging into your Trading Partner Account on the Health PAS Online Portal and following this pathway: Prior Authorizations > Manual, Forms and Criteria Sheets > Prior Authorization Document Library. You may also call Provider Services at 1-866-690-5585 to request a criteria sheet.

A Few Reminders

  • Please go to the Health PAS Online Portal to access the McKesson InterQual Criteria Sheets, the MaineCare Criteria Sheets, and the MaineCare Supplemental Criteria Sheets to ensure you are accessing the most current version.
  • Some McKesson InterQual Criteria Sheets and MaineCare Supplemental Criteria Sheets are meant to be reviewed as a "combo" criteria set. MaineCare policy and criteria shall supersede McKesson InterQual criteria. For example, this is applicable if deciding when it is appropriate to replace a durable medical equipment item or when a second opinion is required.
  • The provider submitting the PA does not need to include the full criteria sheet in the submission to MaineCare. Instead, the provider may print, sign, date, and submit the first page of the criteria sheet, indicating the relevant clinical scenario number, and print only the completed clinical scenario pages for the scenario that applies.
  • There may be procedure codes listed on the McKesson InterQual Criteria Sheets that are not covered by MaineCare. To be covered, a procedure code must be open and active in MIHMS.
  • Please submit a completed Prior Authorization Request form along with the criteria sheets. You can access the Prior Authorization Request form in the Authorizations and Referrals folder, on the Health PAS Online Portal

If you have questions about the PA process, McKesson InterQual Criteria Sheets, or to verify which codes are covered, please contact Provider Services at: 1-866-690-5585.

1/24/2017 5:05 PM

The 2017 Primary Care Payment Increase Attestation Form has been updated. Please ensure you are using the correct version of the form. The 2017 Primary Care Payment Increase Letter and Attestation Form are available on MaineCare’s Provider Resources webpage.

 
Please contact Donna Sutter with question at: (207) 629-4280
1/24/2017 5:05 PM
The MIHMS Provider Known Issues List offers information about Change Requests and Trouble Reports that affect MaineCare Providers. You can sort the list by provider type, issue type, or date. E-mail us with issues to add to the list.