Attention Providers: Instructions to Change Billing Clearinghouse

Mar 20, 2024

As communicated on February 23, 2024, Change Healthcare is experiencing a network interruption related to a cyber security issue. This is a national issue affecting health care systems and Medicaid programs in many states, including Maine.  

We understand that some providers relied on Change Healthcare to submit electronic claims to MaineCare and may now be looking to change their clearinghouse for EDI claim/eligibility verification transactions. Below are steps and resources for providers to make this change.  

Steps for the provider to take:

• Review the MaineCare Approved Billing Agencies and Clearinghouses to search for a clearing house approved for production with MaineCare.
  • The letter ‘P’ in an EDI transaction column indicates the trading partner is approved to submit production transactions. Choosing a clearinghouse in production will provide the quickest way to resume submitting your transactions.
  • The following clearinghouse accounts affiliated with Change Healthcare are currently not functional:
    • RelayHealth
    • RelayHealth Tulsa
    • Emdeon (both)
• Implement the chosen clearinghouses software.
• Once implemented, there are no changes you need to make to your Trading Partner Account. You can begin submitting transactions immediately.
• If your current clearinghouse receives your 835 electronic remittances, you’ll also want to update your provider Trading Partner Account to the new clearinghouse.
  • Please go to our Trading Partner User Guides and open the document for Providers Already Enrolled which gives you instructions on how to make this update.
  • Review section 8.1.2 of that guide and follow the steps to select your new clearinghouse in the dropdown to receive your 835’s going forward.

Steps for the clearinghouse to take:

• If a clearinghouse is either not on the list or not approved for production, the clearinghouse will need to take the following steps:
  • Secure a Trading Partner Account by registering on our MaineCare Health PAS Online Portal
  • Become production certified by completing testing.
• Additional guidance can be found on our Trading Partner User Guides by opening the document titled Trading Partner Guide for Clearinghouses.

If you have any questions about this process, please feel free to contact our Customer Service department at 1-866-690-5585 or email at MaineCareSupport@gainwelltechnologies.com.