MaineCare Member ASO Information

The Department of Health and Human Services (DHHS) selected APS Healthcare in 2007 to be their Administrative Services Organization (ASO).  As an ASO, APS Healthcare helps manage MaineCare's behavorial health care benefit (mental health and substance use services).

Who is APS Healthcare?

APS Healthcare is a health care company that was founded in 1992.  APS Healthcare works with agencies and organizations to improve both mental health and medical healthcare services for more than 20 million Medicaid, Medicare and other health insurance members across the United States and Puerto Rico. 

What is an ASO?

In Maine, APS Healthcare, as an Administrative Services Organization (ASO), works with providers of MaineCare mental health and substance use services. We look at the services requested by providers for each member to make sure they are the right services for the member's circumstances.

What does APS Healthcare do?

APS Healthcare reviews the mental health and substance use services that you or your child gets, based on information sent to us by your provider. We then authorize (or OK) the service. We give the provider an authorization number for each requested service which allows them to bill MaineCare.

APS reviews services with the goal of helping providers and DHHS promote each member’s recovery, resiliency, and ability to live in the community of his or her choice, as well as improve the quality of mental health and substance use services in Maine.

How does this affect me?

APS Healthcare reviews the mental health or substance use services that you get or your child gets. APS Healthcare and your provider, or your child’s provider, will work together to ensure those services fit you or your family member’s circumstances.

You will still have a choice of providers.

If you have or your child has been getting MaineCare, you or your child will still get MaineCare.

What if I do not agree with a decision by APS Healthcare?

You can call us and ask us to look at the decision again. We will then review the service again. You can also have an appeal hearing with DHHS. A full description of the process is in the Member Handbook. You can also call us for a paper copy. Our number is 1-866-521-0027.

Who can I call at APS Healthcare if I have a question?

You can call APS Healthcare Member Services toll-free at 1-866-521-0027.

You can also call our Member Liaison at 1-866-521-0027. This person is a self-identified member. This person is there to answer your questions, help with information, and problem solving.

How else can I get information?

This APS Healthcare website has information about the role of the Administrative Services Organization (ASO). It also includes links to the DHHS website and other relevant websites.

Our Member Handbook has lots of helpful information. It includes our review policies, grievance and appeals information, and our quality management work. This Handbook is on the website. You can also get a hard copy of it by calling APS Healthcare Member Services at 1-866-521-0027.

For additional information regarding Member Services and APS Healthcare, please call
1-866-521-0027.

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