Provider Tips

Mandatory Provider Enrollment in APS CareConnection

Providers do not have to use CareConnection to submit or obtain authorization information. However, in order to obtain a MECMS PA number needed for billing, and an authorization to bill, all providers must register with APS Healthcare, in the APS Healthcare CareConnection® system.

APS CareConnection® MANDATORY Provider Registration Process

1. All providers must register in APS CareConnection®, whether they intend to request an authorization electronically, via phone or fax. If you have not registered to date, please print, fill out and sign the Organization Setup Request form and fax to (866) 325-4752. APS Healthcare cannot approve an authorization request until you have registered in APS CareConnection®.

2. We strongly encourage providers to request authorization electronically via APS CareConnection®. In order to obtain a user logon to APS CareConnection® fax back the User Access Request Form AND the Confidentiality Agreement to (866) 325-4752.

3. When the Organization Setup Request and the User Access Request forms are received back from you via fax, a helpdesk representative will enroll your organization and create your user ids. Once your enrollment has been processed, they will notify you via e-mail or phone that this process is complete and provide you with your user ids.

CareConnection Setup

In CareConnection, the “Organization” is simply a grouping of MaineCare provider ID numbers that the provider uses to bill for its MaineCare services. This grouping can be done several ways depending on the organizational needs of the agency/facility.

For Example:

A Provider may choose to group together under a single CareConnection “Organization”:

1. Broad groups of services, such as: All Children’s Services; or All Adult Services or

2. Single service areas based on service type such as: Adult ACT; or 65M&N Services

3. By location such as “33 Plum Street” or “Brewer Outpatient Office”

4. Providers can use any naming convention that they choose, for the “Organizations”, as noted above.

When submitting an authorization request to APS Healthcare, along with appropriate clinical data, Users must choose:

1. The MaineCare Provider Billing ID (from a drop down list). Only those MaineCare Provider Billing IDs associated with the user’s “Organization” will appear in the drop down list.

2. The Procedure Code for the Service for which they are requesting authorization (from a drop down menu).