Yes, facilities are required to maintain an up-to-date “roster” of attending providers that are affiliated with the facility. Edits will be added to verify the “Attending Provider” has been reported for the “Billing Provider”. (Note: For providers using ePACES, the attending provider is referred to in ePACES as the servicing provider.)

No, physicians are affiliated with a physician’s group NPI through the normal provider enrollment process. The claims for physician groups are submitted using a Professional Claim (837P) format. However, if the physicians are also attending physicians on the hospital’s 837I Institutional Claims, the hospital must report them as affiliated providers with the appropriate hospital NPI. (Note: For providers using ePACES, the attending provider is referred to in ePACES as the servicing provider.)

Facilities with multiple NPIs must maintain a separate roster of attending providers' NPIs and License Numbers for each facility NPI.

Yes, there is a batch process that allows providers to submit files through their current batch submission methods (example: eMedNY Exchange or FTP).

The effective start date should be the date the practitioner first became affiliated with the facility. For the initial load period, you may use a default date of 1/1/2000 for practitioners that were affiliated with the facility prior to 1/1/2006. For practitioners whose affiliation began after 1/1/2006, the actual affiliation effective start date should be used. After the initial load period, the actual affiliation effective start and inactive dates should be used.

Clinics, hospitals and other facilities submitting Institutional Claims (837I) are required to report the NPI and associated License Numbers for attending providers that will be included on claims submitted to NYS Medicaid by the facility. (Note: For providers using ePACES, the attending provider is referred to in ePACES as the servicing provider.)