Provider Enrollment Resources

On January 17, 2024, MaineCare and Gainwell held a listening session about provider enrollment. During this session, many providers indicated that they were not aware of existing provider enrollment resources. In response, we are sharing provider enrollment resources that will help you navigate the enrollment process.

Enrollment Resources

• New! General Overview of Steps to Enroll with MaineCare
• Provider Enrollment Process Questions and Answers (PDF) for frequently asked questions about enrollment.
• Enrollment Frequently Missed Information (PDF) to ensure you submit a complete application.
• Enrollment Status Descriptions (PDF) for details about which step your enrollment application or maintenance case is in the enrollment process.
• The Trading Partner Account for Provider Enrollment manuals. Select Provider on the webpage, then under Helpful Documents select Provider Documents. Then select Provider Enrollment for the New Enrollment, Revalidation, and Maintenance manuals. 

These and other resources are currently found on the Provider Enrollment & Revalidation webpage. For guidance and manuals on how to correctly submit new enrollments, maintenance casers, revalidation cases, and more, see the Enrollment Folder on the Health PAS Online Portal.

Contact Information

• MaineCare Enrollment email box
• Provider Services Call Center: 1-866-690-5585, Option 2 for Enrollment Questions. TTY users dial 711.
• Provider Services Call Center: 1-866-690-5585, Option 7 for Revalidation Questions. TTY users dial 711.
• Contact your Provider Relations Specialist if your case has been open for more than 60 days and/or you are experiencing financial hardship.
• If you need further assistance after contacting Gainwell’s Provider Enrollment Team or your Provider Relations Specialist, please reach out to the Provider Enrollment Manager Kenneth Jamison (KJ).

MaineCare: Unwinding the Public Health Emergency (PHE)

At the beginning of the COVID-19 pandemic, the federal government declared a Public Health Emergency (PHE) and relaxed certain requirements to ensure Medicaid (known as MaineCare) members could continue to access healthcare services. The federal government declared that the PHE would end (also known as unwinding) on May 11, 2023. 

Starting May 12, 2023, some billing flexibilities and how MaineCare members access health care services reverted back to how they were administered prior to the declaration of the PHE.

The Maine Department of Health and Human Services is working to update its COVID-19 and End of PHE web page with current information concerning the end of the PHE and will send notifications as updates are made. 

Following are links to recently added or updated documents:

• End of PHE Copayment Guidance (PDF) - May 11, 2023
• COVID-19 Update for Pharmacies (PDF) - May 11, 2023
• MaineCare Standing Order for COVID-19 At-Home Tests and Collection Kits (PDF) - Updated May 5, 2023

To support MaineCare providers through this transitional period, MaineCare developed a provider-only e-mail box to submit questions related to the end of the PHE.