Verify a Code is Reimbursable for Special Population with Limited Benefits (SPLB)
If you see a member has SPLB MaineCare coverage when verifying eligibility on the Health PAS Online Portal, do not assume the coverage is hospital inpatient services only. There are several different SPLB coverage types and the services MaineCare reimburses for depends on which limited benefit coverage the member receives.
Contact Gainwell Provider Services at 1-866-690-5585 to verify if the procedure code you intend to bill is covered.
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