Update on MaineCare Provider Enrollment Backlogs

• By: Angela Westhoff
• On: 02/08/2024 14:00:01
• In: Legislative/Government Affairs

MHCA continues to be in contact with the Department of Health and Human with respect to the backlog of cases waiting for MaineCare provider revalidation. On a MaineCare Advisory Committee call held this week, the Department noted that there has been a 50% reduction in provider revalidation cases pending with the third-party vendor Gainwell Technologies. The total number of cases pending has dropped from 1,294 cases in November to 619 cases today. 
 
They also reported that the turnaround time on a monthly basis has improved from 55 days to 33 days (calendar days) and that the average age of a case is 28 days. They did note that 36% of cases are beyond 30 days waiting and 16% are over 50 days.

MaineCare continues to experience a high volume of provider enrollment cases. Gainwell regularly identifies missing information that delays their ability to complete cases and requires your immediate attention.  For tips on submitting provider enrollment cases please visit the DHHS website here:

https://www.maine.gov/dhhs/oms/providers/provider-bulletins/attention-providers-please-respond-enrollment-cases-need-more-information-nmi-2024-01-18?utm_medium=email&utm_source=govdelivery
 
If you have questions about your enrollment case, please contact Gainwell Provider Services at 1-866-690-5585, Option 2.

Staff contact: awesthoff@mehca.org