Member Homepage

APS Healthcare was hired by the Department of Health and Human Services (DHHS) to look at the use of some of the mental health and substance use services in Maine. We started December 1, 2007. We only look at and approve services that are paid for by MaineCare. We are called an Administrative Services Organization (ASO). This means we are paid to manage the services. We do not provide any services like a mental health agency. We get paid a flat rate. We do not get paid more or less if we approve a lot of service or a little.

This is how the process works. You and your provider agree on how that provider can best help you, your child, or your family member. You both agree on a treatment plan. The provider sends this clinical information to APS Healthcare. This is called a “review”. It should be the same information that is on the treatment plan you or your family member make with the provider.

APS Healthcare will look at the information from the provider. We look at it based on guidelines called Level of Care criteria. These guidelines, along with diagnosis, strengths, supports, and treatment plan, are what we use to make a decision to approve the provider’s request.

If the service asked for by the provider based on the clinical information is the RIGHT care for you, your child, or your family member, at the RIGHT time, in the RIGHT place, then APS Healthcare will “authorize”, or OK the request. When we give the OK, we give the provider a number to bill MaineCare for the service. MANY services are approved just as requested.

Your provider can keep asking to continue services AS LONG AS NEEDED. Every authorization, or OK, that we give has a time limit. As an example, the provider may get the OK to provide case management services for 6 months. At the end of 6 months, the provider just needs to let us know and give us more information, just like they did last time. We are interested in knowing how you, your child, or family members are doing, and how the treatment is helping you, your child or family member.

Our goal is to promote each member’s recovery, resiliency, and ability to live in the community of his or her choice. It is also to improve the quality of mental health and substance use services in Maine.

If you have ANY questions about what we do, please call APS Healthcare Member Services at 1-866-521-0027/ (TTY/TDD) 207-239-3252.

Important Updates

Member Handbook

Reading .PDF Documents

In order to view the .PDF files, you will need Acrobat Reader.