Personal Care Services (PCS) Providers: Billing Electronic Visit Verification (EVV) Services Submitted on the Health PAS Online Portal with Direct Data Entry (DDE)
Maine Department of Health & Human Services sent this bulletin at 02/09/2021 10:08 AM EST
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Personal Care Services (PCS) Providers: Billing Electronic Visit Verification (EVV) Services Submitted on the Health PAS Online Portal with Direct Data Entry (DDE), CR 99359
The following PCS services are excluded from EVV record requirements when the claims are submitted via DDE on the Health PAS Online Portal and submitted with place of service (POS) 10:
1) Section 28 services when the service is NOT delivered one-to-one within the member’s home or when the service does not include personal care components
2) Sections 12, 18, 19, 20, 21, 29, 96 services when the individual providing the service is a “live-in caregiver”
If providers wish to correct the POS code on an EVV claim that is currently in pend status, you may take either of the steps below.
- Wait for the claim to deny, then resubmit the claim with the corrected information.
- Submit a new claim with the corrected information; the original claim will eventually deny if the EVV requirements are not met.
Do not make a change to the claim that is currently pending.
Updates to Electronic (837P) submission processes to allow the use of POS 10 for the same EVV exclusions have not yet been finalized. We will notify you when this update has been completed.
If you have questions, please contact Provider Services by email or phone at 1-866-690-5585, option 3.