Medical Billing Services in Maine
Remote medical billing and revenue cycle management for Maine practices that bill MaineCare, Medicare, Medicare Advantage and commercial plans such as Anthem Blue Cross and Blue Shield. Cleaner claims, fewer denials and faster payments, with no upfront cost.
A billing team that knows Maine payers
MaineCare pays claims through the state rather than private managed care plans, and Maine has one of the oldest populations in the country, which puts Medicare and Medicare Advantage at the center of most practices' revenue. Many providers are rural and depend on accurate eligibility checks to avoid write-offs.
Provider Concerns handles that work for you, remotely. Our team verifies coverage and plan type before each visit, codes and scrubs every claim, submits it electronically, posts payments and works every denial by reason code. You get a single point of contact and monthly reports on collections, denials and days in A/R, so you always know where your revenue stands.
We work with solo physicians, specialty groups, clinics and multi-location practices across Maine, including Portland, Lewiston, Bangor, South Portland, Auburn and Augusta. Because we work inside your existing EHR or practice management system, there is nothing to install and no disruption to your front desk. Learn more about our medical billing, denial management, claims processing and revenue cycle management services.
What we handle for Maine practices
- Medicare Part B claims through National Government Services (NGS) (Jurisdiction K)
- MaineCare claims, mostly through the state on a fee-for-service basis
- Medicare Advantage plans, with plan-level authorization tracking
- Commercial payers such as Anthem Blue Cross and Blue Shield, Harvard Pilgrim and Community Health Options
- DME claims to Noridian (DME Jurisdiction A)
- Eligibility checks, coding review, A/R follow-up and patient statements
- Monthly reporting on collections, denials and days in A/R
Maine billing rules at a glance
The payer rules that shape how Maine claims get paid. Plan contracts can differ, so we confirm each payer's current requirements during onboarding.
Medicaid program
MaineCare, paid mostly through the state on a fee-for-service basis
Medicaid filing limit
Set by the state program and by each managed care plan contract; we confirm every payer's current window during onboarding
Medicare contractor (Part A/B)
National Government Services (NGS), Jurisdiction K
Medicare filing limit
12 months (one calendar year) from the date of service
DME contractor
Noridian (DME Jurisdiction A)
Major commercial payers
Anthem Blue Cross and Blue Shield, Harvard Pilgrim, Community Health Options, Aetna and Martin's Point
Revenue cycle services for Maine practices
Pick one service or hand us the whole revenue cycle. Either way, you keep full visibility into every claim.
Medical billing
Charge entry, claim scrubbing and electronic submission to every Maine payer you work with.
Learn more →Claims processing
Clean claims built to each payer's edits, so fewer are rejected before they are ever reviewed.
Learn more →Denial management
Every denial worked by reason code, corrected, appealed and tracked until it is paid.
Learn more →Revenue cycle management
Eligibility, coding review, payment posting, A/R follow-up and monthly reporting in one service.
Learn more →Common Maine denials and how we prevent them
Most denials are preventable. These are the ones we see most often for Maine practices, and the checks we run to stop them before a claim goes out.
State Medicaid edits
MaineCare applies its own coding and eligibility edits. We check claims against the program's rules before submission and correct rejections the same week they appear.
Medicare Advantage vs. Original Medicare
Patients move between Original Medicare and Medicare Advantage plans during open enrollment. We verify the plan at every visit so claims don't go to National Government Services when a private plan should be billed.
Missing prior authorization
Many Maine plans require approval for imaging, procedures and specialty visits. We request and track authorizations before the date of service.
Coding and modifier errors
Bundling edits, missing modifiers and diagnosis codes that don't support medical necessity are among the most common avoidable denials. Certified coders review claims before they go out.
Timely filing
Medicare, MaineCare and commercial plans each set different deadlines. We track every open claim against its payer's window so nothing ages out.
Coordination of benefits
Secondary coverage, workers' comp and auto claims need the right payer order. We confirm it up front and bill secondary payers as soon as the primary pays.
Getting started is simple
No long setup and no upfront cost. Here is how Maine practices move their billing to Provider Concerns.
Free billing review
We look at your collections, denials and A/R to find where revenue is being lost.
Payer setup
We confirm your MaineCare, Medicare and commercial enrollments and each payer's rules.
Clean claims
We verify eligibility, code, scrub and submit claims inside your current system.
Follow-up & reports
Denials and aging balances are worked every week, with monthly reporting.
Medical billing across Maine
We support practices statewide, from large metro groups to rural clinics. Billing is handled online, so location is never a barrier.
Specialties we bill for in Maine
Frequently asked questions about medical billing in Maine
Do you bill MaineCare?
Who is the Medicare contractor for Maine?
Which commercial insurance plans do you work with in Maine?
Can you support practices in Portland and other Maine cities?
What is the Medicaid timely filing limit in Maine?
How much does medical billing cost for a Maine practice?
Other states we serve in the Northeast
Ready to get paid faster in Maine?
Get a free billing review. We'll look at your collections, denials and A/R and show you exactly where revenue is being lost.