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A Claims Cycle is a weekly financial processing event in which NYS Medicaid claims are paid and remittance notifications are prepared. Each cycle receives a unique sequential cycle number. In order to have the best chance that your electronic claim submissions are included in the current week’s cycle, please send them to Computer Sciences Corporation (CSC) before 6:00 PM on Monday. CSC will continue processing claims received after 6:00 PM on Mondays, and will get as many as possible into the current cycle. However, you should not have any reasonable expectation that claims received after the Monday cut-off will make it into the current cycle. Those that do not make the cut-off will be included in the next weekly cycle.
CSC returns a 997 (Functional Acknowledgment) Response file for all electronic claim submissions. Submitters will know the cycle in which the claims are processed by interrogating the 997 Response. The file name includes a date and time stamp. Providers who use ePACES can verify if claims were accepted for processing by clicking on the "Submit Claim Batches" function on ePACES, then click on the "Previously Submitted Batches" hyperlink. If the Total Rejected shows a zero (0), it is an acknowledgement that the file was accepted. The second column "Submit Date" can be used to approximately determine when claims will be processed.
If the Response indicates the claims were accepted, the submitter can check the Cycle Calendar for the corresponding cycle information.
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