For Network Providers

Provider Changes and Enrollment

Provider Change Form. Please download and submit the attached provider change form to update us on changes in your practice.

Martin's Point CAQH Form. Please download and complete the attached CAQH Roster form to facilitate credentialing of new physician providers in your practice.  Please note that for Hospital-based physicians such as Hospitalist, Emergency Room, Radiology and Pathology the CAQH form is not necessary.  Please notify Martin’s Point about these providers using the Provider Change form. 

US Family Health Plan Network Providers

Provider Information

Martin's Point Generations Advantage Network Providers

Resources for Providers of Medicare Services

Generations Advantage Plan Information, Authorization Information and Other Provider Resources

We are pleased to be the local option for Medicare Advantage in Maine.  Martin’s Point Generations Advantage is available to seniors in twelve Maine counties. Here are resources for providers on how our plans work.

2010 Generations Advantage Plans – a summary outline of how the 2010 Generations Advantage plans work, member copayments and coinsurance.

Authorization Process Summary (pdf). For your reference, we have developed a summary of the fundamental aspects of our authorization process.

Authorization Requirements (pdf). This requirements grid has been created to include additional services and comments regarding authorization requirements.

Durable Medical Equipment Requirements (pdf). Requirements related to durable medical equipment, specialized wheelchairs, mobility devices and some orthotic services.

Medications Requiring Prior Authorizaiton (pdf). This grid shows the brand name and generic descriptions of medications requiring authorization. Please note that, consistent with Medicare policy, these medications require specific prior authorization to be covered. If not specifically authorized, these medications (as well as related services) cannot be covered by Generations Advantage.

Authorization Request Form (pdf). This is the most updated form providers should use to communicate authorization needs for Generations Advantage members.

Provider Change Form (pdf). Please use this convenient form to report changes to our provider files, such as Tax ID number, adding or removing providers, and address or phone changes.

Request for Claim Adjustment Form (pdf). This form should be used to request adjustment to previously processed claims. Using this form will allow you to adjust your cliams and it helps our claims department easily identify claims requiring adjustment.

Generations Advantage Provider Education Booklet (pdf). Download your own copy of the Generations Advantage provider education booklet.

Providers interested in web access to check status of claims, eligibility, and authorization should contact our Provider Inquiry Department at the number below. Access is free.

We appreciate your continued support to the Generations Advantage plans and our authorization process. Please remember that the authorization requests are to be submitted in advance and that services requiring authorizations are denied if they have not been approved by the Martin's Point Health Management Department.

If you have any questions, please contact the Provider Inquiry Department at 1-888-732-7364 or call your Network Representative.