Provider Enrollment Presentation Follow-Up and Progress Update

Feb 13, 2024

On January 17, 2024, the Office of MaineCare Services (OMS) and Gainwell held a listening session about provider enrollment. During this session, providers asked questions and shared suggestions about how to improve the enrollment, revalidation, and maintenance case submission process and case review process. We appreciate the time that providers took to attend, participate, and share their ideas to improve these processes. We are committed to improve these processes for the benefit of MaineCare members and providers. 

Please see the Provider Enrollment Listening Session Q&A document for the questions we captured during the listening session, along with answers from MaineCare and Gainwell. 

We are developing a document to share provider suggestions captured during the listening session. We will send out further communication once this document is available.  

We also have Other DHHS Office Contacts and Enrollment Status Descriptions documents available. 

You can find all documents, as well as the listening session presented materials, on the Provider Enrollment & Revalidation webpage. 

Progress update 

Gainwell has reduced the number of open cases and the time it takes to complete their steps within the process. Case inventory decreased from 1,294 cases in November 2023 to 610 cases in early February 2024. The average turnaround time decreased from 55 days in November 2023 to 33 days in January 2024. We anticipate further improvements. 

 

Additionally, OMS and Gainwell are sharing the following updates: 

• Gainwell has three system and process enhancements related to provider enrollment scheduled to go live in February 2024.  

• Gainwell and OMS are assessing and researching further system enhancements, such as automating facility licensure. 

• OMS recently filled a state vacancy on the provider enrollment team. We are also training a member of our Provider Relations team to cover some provider enrollment responsibilities.