Intelligent Value

Provider Manual

The Manual is intended to be used as a reference guide to support and inform Providers:

• On the processes that Acentra Health utilizes to achieve the goals and contractual requirements set by the state for the Administrative Services Organization agreement.
• To understand which programs and services Acentra Health has been contracted to support through this agreement.
• To use the tools and supports available to the Provider to ensure access and continued care to the members of our community.

For any questions or feedback please e-mail: ProviderRelationsME@kepro.com

• Provider Manual  (Updated November 2023)
• MaineCare Funded Service Grid (Updated April 2024)
• Non-MaineCare and OBH Funded Service Grid

Submission Forms

• Atrezzo Submission Form 

SUD Treatment Data Forms

• SUD Treatment Admissions Form
• SUD Treatment Discharge Form
• SUD Drug Code Table

Release of Information Form

To obtain a Release of Information form, please follow the below link to access the DHHS Authorization to Release Information Form. 

• Authorization to Release Information Form
• Authorization to Release Information Form Example

If you would like to request any of the documents listed on this page, please contact Acentra Health Provider Relations at 866.521.0027, Option 3, or via email at ProviderRelationsME@kepro.com.