Secondary Billing Instructions Updated

Nov 20, 2023

MaineCare’s Secondary Billing Instructions have been updated to reflect the following.

When billing MaineCare secondary claims, you must attach an Explanation of Benefits (EOB) to all claims regardless of submission type:

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

When submitting electronically, you will need to upload the EOB once the claim is in MIHMS. The charges billed on 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.  

Supplemental Billing Info - Publication (maine.gov)

For questions, please contact your Provider Relations Specialist.