Medicaid Management Information Systems Maine Integrated Health Management Solution
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Usage Information Documents published herein are furnished “As Is.” There are no expressed or implied warranties. The content of this document herein is subject to change without notice. HIPAA Notice This Maine Health PAS Online Portal is for the use of authorized users only. Users of the Maine Health PAS Online Portal may have access to protected and personally identifiable health data. As such, the Maine Health PAS Online Portal and its data are subject to the privacy and security regulations within the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA). By accessing the Maine Health PAS Online Portal, all users agree to protect the privacy and security of the data contained within as required by law. Access to information on this site is only allowed for necessary business reasons, and is restricted to those persons with a valid user name and password.
1. Introduction 1 2. System Requirements 2 3. Preparation for PA Submission Process 2 4. Trading Partner 2 5. Prior Authorization Submission 4 5.1 Patient Roster or Primary Care Roster 4 5.2 Authorization Submission 5 6. Submit Prior Authorization 8 7. Authorization Confirmation 16 8. Add Attachments to Prior Authorization 18 9. Prior Authorization Cover Sheet 19 10. View Authorization Status 20 10.1 View Attachments 24 11. Print Detail 25 Appendix A. CT and PET CPT Procedure Codes 27 Appendix A. CT and PET CPT Procedure Codes 27 List of Figures and Tables Figure 4 1: Trading Partner Sign In 3 Figure 5 2: Form Entry– Authorization Submission 4 Figure 5-2: Patient Roster 5 Figure 5-3: Primary Care Roster 5 Figure 5 4: Billing Provider 6 Figure 5 5: Member Search 6 Figure 5 6: Member Search Results 7 Figure 6 3: PA Detail Screen 8 Table 1: Authorization Information Tab 9 Figure 6 4: Rendering Provider Search 9 Figure 6 5: Provider Search Results – With Rendering Providers 10 Figure 6 6: Provider Search - Without Rendering Providers 11 Table 2: Diagnosis Fields 12 Figure 6 7: Search for Diagnosis Code 12 Figure 6 8: Diagnosis Search 12 Figure 6 9: Diagnosis Search Results 13 Figure 6 10: Diagnosis Description 13 Table 3: Field Name and Field Description 14 Figure 6 11: Service Code Search 14 Figure 6 12: Service Code Search Window 14 Figure 6 13: Service Code Search Results 15 Figure 6 14: Service Line Example 15 Figure 6 15: Miscellaneous Information 16 Figure 6 16: Notes 16 Figure 7 17: Confirmation Page 17 Figure 7 18: View Appeal Rights 18 Figure 8-1: Add Attachment 19 Figure 9-1: Prior Authorization Cover Sheet 20 Figure 10 19: Form Entry-Authorization Status 21 Figure 10 20: Authorization Search 22 Figure 10 21: Authorization Status 22 Table 4: View Authorization Detail Functions 22 Table 5: Prior Authorization Disposition Codes 23 Figure 10 22: View Authorization Detail 24 Figure 10 23: View Attachment Button 24 Figure 10 24: View Attachment 25 Figure 11 25: Print Detail 25 Figure 11 26: Authorization Detail 26 Table 6: CT and PET Codes 27
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