Attaching an Explanation of Benefits (EOB) to Secondary Claims

Apr 22, 2024

When billing MaineCare secondary claims, you must attach an EOBA to all claims regardless of the submission type listed below:

• Direct Data Entry (DDE)
• Paper
• Electronic Data Interchange (EDI)

When submitting electronically, upload the EOB once the claim is in MIHMS. The charges billed on the claim lines must match the charges billed on the EOB, or the claim will be denied.

When all lines have a payment from the primary insurance carrier, enter primary insurance payment information at the line level. If there are lines that do not have a payment due to a denial, or bundled service, enter the payment information at the header level.  

For more detail, see the Supplemental Billing Info folder on the Health PAS Online Portal.

For questions, please contact your Provider Relations Specialist.