Workers compensation runs on a state fee schedule, state forms, and state timelines. A process that works in one state is frequently invalid one state line away, which is why it is so often the worst-performing segment of a practice’s A/R.
Claims for Maine providers are adjudicated by National Government Services (JK), which is also who hears the first level of appeal — so an appeal argument that works here works in every state that contractor covers.
At a glance
Medicare contractor
National Government Services (JK)
Medicaid program
MaineCare
Managed care
Limited comprehensive managed care
Auto injuries
Tort state — health plan sequencing applies
What changes in Maine
Medicaid in Maine runs as MaineCare, and Maine operates limited comprehensive managed care — so claims are largely billed to the state directly rather than to a plan, which is now the less common arrangement nationally.
What we do
- Bill against the applicable state fee schedule rather than your commercial rates
- Track authorization and reporting requirements specific to the jurisdiction
- Manage the documentation these carriers require and commercial payers do not
- Follow up on the longer payment cycles these claims run on
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your Maine aging and denial mix.
Scope
A written scope and price before any work starts.
Transition
No gap in submission during the handover.
Report
Six numbers monthly, segmented by payer.
Workers Compensation Billing in Maine — Frequently Asked Questions
Which Medicare contractor covers Maine?
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National Government Services (JK). That is who adjudicates your Medicare claims and who hears a redetermination.
Is Maine Medicaid managed care?
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MaineCare runs with limited comprehensive managed care, so most claims go to the state directly.
Ready for books you can actually trust?
Book a free consultation and we will tell you what your revenue cycle needs and what it costs.
- Done-for-you
- Solo or group
- Nationwide
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