STATE OF NEW YORK
DEPARTMENT OF HEALTH
eMedNY
MEVS
Batch Authorizations
TABLE OF CONTENTS
Section
1.2 Availability
of eMedNY.. 1.0.
2.0 Obtaining an eMedNY Access
3.0 File Format Specifications
4.0 FTP FILE PREPARATION PROCEDURES
Provider
Electronic Transmission Identification Number (ETIN) Application
AGREEMENT for eMedNY System ACCESS
The New York State Medicaid Eligibility Verification System (MEVS) requires the use of the HIPAA compliant Eligibility transaction formats. The formats will be accepted via File Transfer Protocol (FTP) or CPU-CPU link.
This method is the standard process for batch authorization transmissions. FTP allows users to transfer files from their computer to another computer (upload) or from another computer to their computer (download). Each batch file transmission sent to the eMedNY contractor is required to be completed within two hours. Any transmission exceeding two hours will be disconnected.
The eMedNY system is available 24 X 7. In the event of a system problem, you may call CSC’s Provider Services Department at 800 343-9000. User support is available Monday through Friday between 7:00 AM and 10:00 PM, and 8:30 AM to 5:30 PM on Saturday, Sunday and holidays. You may contact CSC’s Provider Services Department at 800 343-9000.
While the intent has been to provide sufficient concurrent telephone connections, it is possible that you may encounter a busy signal. Please try again at a later time.
Upon completion and subsequent filing of the electronic certification statement you will be given two pieces of information. The first is your user identifier and the second is your initial password. You will be required to change your password when you access the eMedNY the first time. Make sure you record your new password and store it in a secure place.
If you lose or forget any component of your access key, or suspect an unauthorized person may have knowledge of your access key, please call the CSC Provider Services Department immediately. You are responsible for any action taken on behalf of your account.
Refer to Security Packet B containing the forms to obtain an eMedNY user access key.
Please refer to the Companion Guides on the eMedNY.org website for the following HIPAA Medicaid Eligibility companion guides to obtain the correct file and record formats.
Access the Companion Guides by referring to www.hipaadesk.com/?nymedicaid under the "News and Resources" tab.
· 270: 270 Eligibility Inquiry Request NYSDOH Companion Guide (4010X092A1)
· 271: 271 Eligibility Inquiry Response NYSDOH Companion Guide (4010X092A1)
· 278: 278 Services Request NYSDOH Companion Guide (4010X094A1)
· 278: 278 Services Response NYSDOH Companion Guide (4010X094A1)
The electronic specifications contain the requirements and procedures that must be followed when submitting electronic media
- The “Binary” option must be activated prior to sending or receiving files. Therefore, following your logon to the FTP ID, type “Binary” at the FTP prompt and hit enter.
- To send files type, “Send” at the FTP prompt and hit enter. To receive files type “Recv” at the FTP prompt and hit enter.
- Using PKZIP or WinZIP, a file must be zipped prior to sending files to the FTP ID.
- Using PKZIP or WinZIP, a file must be unzipped after downloading a response file from the FTP ID.
- When sending a file, the following Dataset Naming Standard for the remote file is required:
Node1.Node2.Node3
where,
Node1 = ‘P’
followed by the first seven digits of your provider number (i.e. P1234567)
Node2 = ZIP
Node3 = Generation/File
number in the following format (G000?V00), where ? = the file you are sending
for the day.
Using
the example above, the completed remote
file would be:
P1234567.ZIP.G0001V00
(1st file for the day)
P1234567.ZIP.G0002V00
(2nd file for the day)
P1234567.ZIP.G0003V00
(3rd file for the day)
- When receiving a file, the remote file will be entered using the following naming standard:
NodeA.NodeB.NodeC
where,
NodeA = ‘P’
followed by the first seven digits of your provider number (i.e. P1234567)
NodeB = ‘D’
followed by the date in the YYMMDD format.
NodeC = ZIP
The following forms are included in the manual:
·
Provider Electronic Transmission Identification Number
(ETIN) Application
· AGREEMENT for eMedNY System ACCESS (Security Packet B)
To apply for your Electronic Transmission Identification Number (ETIN), which is required in order to submit data electronically for processing by the New York State MMIS or eMedNY, please complete the items below and forward along with a Certification Statement to:
ATTN: MAGNETIC
MEDIA LIAISON - FIRST FLOOR
CSC HEALTHCARE
SERVICES
800 NORTH PEARL
STREET
ALBANY, NY 12204
* PLEASE NOTE: If you are
adding a new Provider ID Number to an existing Electronic Transmission Identification Number (ETIN) send ONLY the Certification Statement.
1. PROVIDER NAME:
__________________________________________________________
2. PRIVIDER ADDRESS: _______________________________________________________
(STREET)
________________________________ _____________ _______________________
(CITY) (STATE) (ZIP CODE + 4)
( )-______________________ _____________ ( )-____________________
(TELEPHONE
NUMBER) (EXTENSION) (FAX Number)
3. ADMINISTRATOR'S NAME __________________________________________________
4. CONTACT PERSON'S NAME ____________________________________________
TELEPHONE
NUMBER __________________________________________________
5. MMIS PROVIDER NUMBER(S) ____________________________________________
(NOT
GROUP #)
SIGNATURE OF PERSON(S)
AUTHORIZED TO SIGN PROVIDER MAGNETIC INPUT TRANSMITTALS.
________________________________________ ______________________________________
(NAME
PRINTED) (SIGNATURE)
________________________________________ ______________________________________
(TITLE) (DATE)
________________________________________ ______________________________________
(NAME
PRINTED) (SIGNATURE)
________________________________________ ______________________________________
(TITLE) (DATE)
SECURITY
PACKET B
AGREEMENT
for eMedNY System ACCESS
Instructions for Completion
1.
Please read
the Agreement. Your signature indicates acceptance to the terms and conditions
of this Agreement.
2.
Complete the
information requested at the bottom of the Agreement form and sign the
Agreement. Please print or type the following information:
a)
Provider
Number (Only for enrolled providers or vendors with an assigned Medicaid ID
number. Otherwise leave this field blank.)
Enter your eight-digit Medicaid Provider ID Number, which was assigned by
the Department of Health at the time of your enrollment in the Medicaid
program.
b)
Provider/Vendor
Name
Enter the name of the
Provider/Vendor that will be subject to the agreement. (If you have a Medicaid
Provider ID, enter the name associated with the Provider ID Number entered
above).
c)
Street Address,
City, State, Zip
Enter the address where you would
like to receive correspondence from CSC. Please note that it must be a Street Address, not a P.O. Box.
d)
By
Print the name of the authorized
person who signs the Agreement.
e)
Title
Print the title of the authorized
person who signs the Agreement.
f)
Date
Enter the date on which the
Agreement is signed.
WHEREAS, the New York State Department of Health (the “Department”) and Computer Sciences Corporation (“CSC”), have entered into an agreement whereby CSC provides direct electronic access to MEDICAID eligibility verification, claims submission, and other electronic transactions, for Medical Providers/Vendors and their agents (Provider/Vendor) to the eMedNY System; and
WHEREAS, Provider/Vendor performs certain medical services and/or provides medical supplies for recipients who are eligible for MEDICAID benefits, or performs data processing services for such entities; and
WHEREAS, Provider/Vendor has requested direct electronic access to the eMedNY System;
NOW, THEREFORE, CSC and Provider/Vendor agree as follows:
1.
CSC-eMedNY
will supply to Provider/Vendor the technical specifications required to
establish the link to the eMedNY System (Exhibit A). Provider/Vendor is
responsible for all costs associated with complying with such requirements.
2.
Provider/Vendor
agrees to comply with the system requirements and any additional terms set
forth on Exhibit A.
3.
After Provider/Vendor
has obtained initial access to the eMedNY System, Provider/Vendor agrees to
re-test its link to the System in the event:
·
Provider’s/Vendor’s
link is changed or modified in any way, or
·
The technical specifications
change in response to Department mandated program changes
Provider/Vendor
agrees to follow CSC’s then current procedures for obtaining such access.
4.
Provider/Vendor
agrees to pay any damages that are caused by, result from, or are in any way attributable
to Provider/Vendor, its employees’, agents’ and independent contractors’
negligent use of the eMedNY System, fraud or intentional misconduct or
Provider’s/Vendors’ failure to certify or re-certify its link to the eMedNY
System.
5.
Provider/Vendor
agrees to exercise due diligence in protecting Provider/Vendor systems so that
malicious software is not introduced to eMedNY Systems.
6.
Provider/Vendor
accepts and agrees to comply with the Provisions of the attached eMedNY
Security Agreement.
7.
This Agreement
shall become effective upon approval by CSC-eMedNY, on behalf of the New York
State Department of Health and shall continue thereafter until terminated by
either party on 60 days notice in writing.
By:
Provider Number Please
print name
By:
Provider/Vendor Name Signature
Title:
Street Address
Date:
City,
State, Zip
AGREEMENT for eMedNY System ACCESS
**EXHIBIT A**
SYSTEM REQUIREMENTS
1. Interactive Host-to-Host (CPU-CPU):
o SNA Protocol (LU6.2)
o Compliance with Data Stream Formats
2. Batch Host-to-Host:
o SNA Protocol
o Compliance with File Formats
3. Interactive PC-to-Host:
o Third Party Software:
· VISA-2 Protocol
· Compliance with Data Stream Formats
o Medicaid Eligibility:
· 233 MHz Pentium
· 32MB RAM
· 20 MB HDD
· 14400 BAUD Modem
· Windows 95
· Analog Telephone Line
4. Batch PC-to-Host (Dial-up FTP):
· Point-to-Point Protocol (PPP)
· TCP/IP Protocol with File Transfer Protocol (FTP)
· Compliance with File Formats
OTHER TERMS
1. Provider/Vendor shall order the telecommunication lines and equipment necessary to link Provider’s/Vendor’s system to the eMedNY System. Provider/Vendor will be responsible for monitoring, diagnosing and establishing dial backup on the telecommunication lines and equipment.
2. CSC does not provide consultation services beyond simple installation troubleshooting. For example, we cannot assist with the installation of the operating system or configuration issues involving the Provider’s/Vendor’s LAN, PC, modem or printer. CSC does not support Provider/Vendor hardware or software.
3. When CSC provides the State of New York Medicaid Eligibility software, the software is supplied “AS IS” AND CSC MAKES NO REPRESENTATIONS OR WARRANTIES, EXPRESSED OR IMPLIED, WITH RESPECT TO THE SOFTWARE. In no event shall CSC be responsible for any damage to Provider’s/Vendor’s property which arises out of or is related to Provider’s/Vendor’s use of the Medicaid Eligibility, claims submission, and other electronic transaction software.
4. For qualified Providers/Vendors, CSC will provide support for the Medicaid Eligibility, claims submission, and other electronic transaction software supplied by CSC, so long as CSC is the State of New York eMedNY contractor and Provider/Vendor has not altered or modified the software in any way.
PROVIDER/VENDOR eMedNY Access Request Form
Instructions for Completion
Please type or print all required information.
1. User Information (User is the Provider
enrolled in the New York State Medical Assistance Program [Medicaid] or the
Vendor that supplies
switch
services to a group of providers)
Name
q
If you are an
individual Provider, enter your last name, first name, and middle initial (if
any)
q
If the Medicaid
Provider ID number applies to a business (i.e. Pharmacy, DME Supplier,
Laboratory, etc.), enter the name of the individual authorized to sign the
eMedNY Access Request on behalf of the provider organization.
q
If you are a Vendor, enter
the Company name.
Address
Enter
the address where you would like to receive correspondence from CSC.
Indicate
Check
the box (only one box please) that best indicate your user status. If you check
the box next to Other, please
explain.
Medicaid Provider ID (only
for enrolled providers or vendors with an assigned Medicaid ID number;
otherwise, leave this field blank.)
Enter
your (or your organization’s) eight-digit Medicaid Provider ID Number, which
was assigned by the Department of Health at the time of enrollment in the
Medicaid program.
Phone Number
Enter
the phone number at which you can be contacted.
2. Alternate Access Required
Enter
the reason for which you are requesting access to eMedNY.
3. Requestor Information
Requestor’s Name
Enter the name of the authorized person requesting access to eMedNY.
Date
Enter the date on which the request was completed.
Phone Number
Enter the phone number at which CSC can contact you if necessary.
LEAVE SECTIONS 4 AND 5 BLANK.
THESE ARE FOR CSC USE ONLY.
PROVIDER/VENDOR eMedNY
Access Request Form
SECURITY
AGREEMENT FOR
NEW YORK
STATE-eMedNY SYSTEM
Instructions for
Completion
1. Please read the USERID AND PASSWORD RULES. By signing the Agreement you indicate acceptance to the terms and conditions of this Agreement.
2. Complete the information requested at the bottom of the Agreement form and sign the Agreement. Please type or print the following information:
a) Provider Number (only for enrolled providers or vendors with an assigned Medicaid ID number; otherwise leave this field blank).
Enter your eight-digit Medicaid
Provider ID Number, which was assigned by the Department of Health at the time of
your enrollment in the Medicaid program.
b) Provider/Vendor Name
Enter the name of the Provider/Vendor that will be subject to the agreement. (If you have a Medicaid Provider ID, enter the name associated with the Provider ID Number entered above).
c) Street Address, City, State, Zip
Enter the address where you would like to receive correspondence from CSC. Please note that it must be a Street Address, not a P.O. Box.
d) By
Print the name of the authorized person who signs the Agreement.
e) Title
Print the title of the authorized person who signs the Agreement.
f) Date
Enter the date on which the
Agreement is signed.
SECURITY
AGREEMENT
NEW YORK STATE-eMedNY SYSTEM
All users of Medicaid data and systems are required to affirm their understanding and agreement to comply with the following USERID and Password rules before access can be granted.
USERID AND PASSWORD RULES
A USERID and password will
be provided by CSC-eMedNY Data Security upon approval of this security agreement.
CSC, in accordance with the Federal Information Processing Standards and the
Privacy Act of 1974, requires that all users of the system be aware of and
comply with the following rules regarding USERIDS and Passwords:
a. USERIDS
and Passwords must not be shared with anyone.
A USERID is assigned by CSC-eMedNY Data Security solely to an individual
and the individual is responsible for all system activity related to that
USERID.
b. After
four consecutive password violations (i.e., entering the wrong password) the
USERID is revoked. If this occurs
CSC-eMedNY Data Security Administration intervention is required to reactivate
the USERID. Contact Provider Relations
to activate this intervention.
I have read and fully
understand the USERID and Password rules as set out above.
Please provide a unique identifier, which will be
used to authenticate this Provider/Vendor when corresponding via phone. This identifier should be something only
this Provider/Vendor knows and will be used to verify that the Provider/Vendor
is who they indicate they are when we are asked to provide sensitive
information such as account passwords.
Unique identifier
By:
Provider
Number Please
print name
________________________________________ ____________________________________
Provider/Vendor
Name Signature
Title:
Street
Address
Date:
City, State, Zip