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Attention Hospitals currently billing under the APG Methodology:

In order to allow sufficient testing, the July version of the APG Grouper will not be installed until July 2, 2009. Based upon current billing patterns, the expectation is that this one day delay should not have any effect on the vast majority of providers submitting APG claims. However, if you normally submit claims the day in which services are rendered, then it is recommended that you hold claims with a July 1, 2009 service date for at least one day and wait to submit them on or after July 2, 2009.

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Attention ARU (Telephone) Users

Medicaid will soon begin enforcing use of the NPI on Eligibility Verifications, Service Authorizations and Check Amount Inquiries submitted over the eMedNY Telephone Verification System. Please see ARU NPI Compliance Letter.

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Attention MEVS Users

Medicaid will soon begin enforcing use of the NPI on MEVS transactions. Please see MEVS NPI Compliance Letter.

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Important Information for Providers who Administer Drugs

Please see January 2009 Letter.

Billing Guidelines for Claim Form eMedNY-150002 are available by selecting one of the links below:

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Attention Physician Providers

Please take the time to let CSC and the New York State Department of Health know how we are doing in terms of assisting you in your endeavor to submit Medicaid claims successfully. You may click on the following survey and after making entries, simply click the submit button: Physician Satisfaction Survey.

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Attention NYC Transportation Providers

Effective April 23, 2009, the eMedNY 389702 form replaces both the eMedNY 389701, and the Group Transportation Prior Approval Request Form, the eMedNY 410601. Please see updated City of New York Transportation Ordering Guidelines Manual for more information on form depletion and usage.

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Attention Pharmacy Providers

Important Notice to use the NPI on Your Medicaid Healthcare Transactions. Please see Letter from NYS Department of Health.

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Attention Providers

Important Notice to use NPI on all Medicaid Healthcare Transactions

Effective March 25, 2009, the Department of Health is requiring that all affected providers submit their transactions with a NPI. At this time, pharmacies do not have to comply with this mandate. For more information on how this impacts your claims, please view the NPI letters below that have been sent to providers who are submitting claims without the appropriate NPI.

Providers should review their remittances (paper or 835 supplemental). If the remittances are showing MMIS Edits 02020- Missing Billing Provider NPI or 02021-Missing Pay-to (Group) NPI- providers will be impacted and Medicaid will start denying these claims as of March 25, 2009 if the appropriate NPI is not present.

Some providers do not meet the definition of a healthcare provider, according to HIPAA standards. These providers are known as “ATYPICAL”. This notice does NOT apply to atypical providers. Visit the following link to view a list of atypical providers: Atypical Providers.

The NPI letters recently mailed to providers are as follows:

Letter to Billing Providers

Letter to Group Practice Providers Reporting no Group NPI

Letter to Group Practice Providers Reporting no Billing Provider NPI

Complete instructions for NPI entry with eMedNY is available in the Companion Guides (CGs) posted on the eMedNY website. To view the CGs, please visit the “Technical Guides Section” of the Companion Guide page .

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Attention APG Providers

APG delayed for some provider types.

For more information see the APG Delay Notice.


This website is provided as a service for providers and the general public, as part of the offerings of the electronic Medicaid system of New York State. You'll be able to find helpful manuals and reference material, and get answers to questions about New York Medicaid. The site is updated regularly to meet the ever-growing needs of the New York State provider community. If you need help finding what you're looking for, please visit our Site Map, use the search above, or you can contact us directly for assistance.

About eMedNY
eMedNY is the name of the New York State Medicaid program claims processing system. The system allows New York Medicaid providers to submit claims and receive payments for Medicaid-covered services provided to eligible clients. eMedNY offers several innovative technical and architectural features, facilitating the adjudication and payment of claims and providing extensive support and convenience for its users. Computer Sciences Corporation (CSC) is the eMedNY contractor and is responsible for its operation. More information about this web site can be found at the tabs located on the left-hand side of this page.

DISCLAIMER
The Department has attempted to ensure that the information contained in this website is as accurate as possible. However, the department makes no warranty or guarantee either expressed or implied concerning the accuracy or reliability of the content of this web site. No posted information or materials provided are intended to constitute legal or medical advice.

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