Please have the following information available when calling to status a claim(s) through Maryland Health Partners: The billing provider number, The consumers social security number or medical assistance number, and no more than three dates of service per individual member.

Each provider, who has a Medicaid provider number, will receive a login name and password for the new authorization web-site. The purpose of this web-site is to verify authorizations that have already been issued. Once a provider has received his/her password, he/she should refer to the MAPS-MD web-site (MAPS-MD.com) for instructions on accessing and utilizing the site. Please allow at least one business day for authorizations obtained over the phone and ten working days for the authorizations received via fax or mail to be posted on the web-site.

Some providers can expect to receive retraction notices for duplicate claims payment. There are 30 days to compare/research past billing accounts, with an additional 60 days to submit corrected claims.

The procedure encouraged to follow includes:

Maryland Health Partners has been tracking providers who have heavily submitted duplicate claims. This is not cost effective and resource draining for the entire process. Each provider will be notified and will receive a letter of notification for charges on duplicate claims submitted. (Providers who consistently submit duplicates) Please contact the claims customer service at 800-565-9688 if there are individual questions.

MAPS-MD’s new clinical fax number has been in effect since November 1, 2001. Please remember that any authorization plans faxed to MAPS-MD must be faxed to (410) 953-1903. This is a secure fax machine established to protect the confidential information associated with treatment plans. Faxing authorization plans to any other fax lines at MAPS-MD may result in the plan not being reviewed. MAPS-MD made this change to accommodate HIPAA regulations and to ensure accurate receipt and handling of authorization plans. Preferably, authorization plans should be mailed to MAPS-MD for better legibility and to ensure that all required pages stay in tact. Thank you for your cooperation with this new procedure.

In an effort to enhance our operations and to better assist the providers and consumers of the Public Mental Health System, we are scheduling ongoing staff training from 8:30 A.M. – 10 A.M. for the first Tuesday of each month. During this staff-training period, MAPS-MD will provide an abbreviated amount of staff to service inpatient pre-certifications, crisis line, and consumer calls – only. Staff training will improve customer service, enhance staff development, and increase staff retention. 

Effective January 1, 2002, all clinical and rehabilitative services authorized in the PMHS with the exception of traditional outpatient services, emergency room visits, labs, hospital consultations and nursing home consultations must be pre-authorized. Maryland Health Partners care managers will not authorize any requests for services once the services have already been rendered.

The initiation of traditional outpatient services is considered a registration which should occur before treatment begins or as soon thereafter as possible. If the consumer has been in treatment with another provider, it is possible that claims will reject for lack of authorization if the consumer has not been registered prior to the submission of the claim.

Effective January 1, 2002 MAPS-MD will no longer accept reconciliation forms attached to treatment plans. The Care Management Unit by means of a phone review will handle all requests for additional care during the time period for which services have already been authorized. If the request meets medical necessity, a new authorization will be issued with a new number of visits authorized, in addition to a new authorization time period. If the request for additional services does not meet medical necessity, the request will be sent to a Physician Advisor for determination. A pattern of using more visits than authorized may trigger an audit.

Effective January 1, 2002, claims from the following practitioners will require the inclusion of an appropriate PMHS diagnosis or the claims will be denied: