Revalidate with MaineCare to Avoid Claim Denials

The Affordable Care Act (ACA), Section 6401, states that almost all provider types must revalidate their information with MaineCare every five years. Durable Medical Equipment (DME) providers are required to revalidate their information with MaineCare every three years. The current round of revalidations began in January 2022.   

Annually, MaineCare posts an updated list of providers who are due to revalidate in the current calendar year which is found on the Enrollment and Revalidation webpage.   

You will receive letters 60 days and 30 days prior to your assigned revalidation date. You can initiate your revalidation through the Health PAS Online Portal on, or after, your assigned revalidation date.    

Providers must revalidate their information or MaineCare will deny your claims.   

To allow ample time to complete revalidation before the due date, we recommend you complete all maintenance cases two weeks prior to starting your revalidation case. An open maintenance case will delay your ability to begin revalidation.   

Utilize the revalidation checklist and tips documents to avoid application delays.    

Please review the updated Enrollment Checklist and Provider Revalidation Tips in the Provider Enrollment folder prior to revalidating or enrolling with MaineCare to verify that you have all the required documentation available. The checklist includes information about what is required for enrollment and revalidation for each provider type. We also include common errors found when submitting revalidation applications through the Provider Enrollment Application (PEA). These tips will help you avoid application processing delays. Submitting an incomplete application may result in a delay or denial of your application.    

Training is available.    

MaineCare is committed to keeping you informed throughout the enrollment and revalidation process. You can register for training courses related to revalidation through the Absorb training platform. If this is your first time using the Absorb training platform, go to the Absorb training site and follow the instructions to create your login credentials. If you would like to request a live training session, you can contact Provider Services at 1-866-690-5585. After entering your NPI, choose Option 7; TTY users dial 711.    

The following resources are available to assist you with the revalidation process:   

Provider Services Call Center: 1-866-690-5585. After entering in your NPI, choose Option 7; TTY users dial 711.


 

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