Medical billing services in Maine
Billing, coding, credentialing and A/R follow-up for providers in Maine.
Billing in Maine: what is different
MaineCare is largely fee-for-service.
Key payers and contractors in Maine
- Medicare Part A/B
- National Government Services, Jurisdiction JKPortal: NGSConnex
- Medicare DME
- Noridian, DME MAC Jurisdiction ADME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- MaineCare
- Blue Cross Blue Shield
- Anthem Blue Cross and Blue Shield
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Maine providers
- Medicaid enrollment and revalidation with the state, plus credentialing with any managed care or behavioral health plan that applies
- Medicare enrollment through PECOS and claims with National Government Services through NGSConnex
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s coverage and plan before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Maine: common questions
Do you bill MaineCare?
Yes. MaineCare pays most claims directly through the state, so we bill it fee-for-service and follow its prior authorization and documentation rules.
Who processes Medicare claims in Maine?
Medicare Part A and B claims in Maine are processed by National Government Services (Jurisdiction JK), and we submit and track them through NGSConnex. DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction A), through the Noridian Medicare Portal (NMP).
Can you credential new providers in Maine?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Maine.
Neighboring states and key payers
Get a free billing audit for your Maine practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.