Testing of X12 “HIPAA” transactions is accomplished by submitting files through one of the established transmission methods, such as eMedNY eXchange, SOAP, or by an FTP connection.

A test submission is indicated to the system by a value of “T” in the Usage Indicator of the ISA (Interchange Header) segment, in data element ISA15.

Use the following link to access the Provider Test Environment Users Guide.

Software vendors are not required to test, unless they also perform the function of a clearinghouse.

If, in your capacity as a Software Vendor to NYS Medicaid providers, you transform and transmit electronic claims and/or other “HIPAA” electronic health care transactions to the eMedNY system for your clients, you are the transaction submitter, and are acting as a Health Care Clearinghouse as defined in HIPAA. NYS policy requires software vendors who fall into this category to have a “Service Bureau” NYS Medicaid ID and an Electronic Transmitter Identification Number (ETIN) as well as a unique User-ID and password. As the submitter, it is your responsibility to test.

Note that when the vendor submits electronic claims in the ASC X12 837 format, the vendor’s NYS Electronic Transmitter Identification Number (ETIN) will be sent in the Submitter loop (Loop-ID 1000A). The Provider’s NPI (or NYS Mediciad ID for Atypical providers) will be sent in the Billing Provider loop (Loop-ID 2010AA).

The Billing NPI (or NYS Medicaid ID) and ETIN will need to be certified.

If your business relationship with your clients involves licensing software for their use, but does not involve you submitting electronic healthcare transactions on their behalf, your client, as the submitter, should test their transactions. It is not permissible for the client to share their login information (User-ID and password). Therefore, a collaborative approach between software vendor and provider should be taken to resolve any issues.

Once you have successfully completed testing and validating your HIPAA compliant transactions, you (Software Vendor) will need to periodically check the New York Medicaid HIPAA Web Site for Companion Guide updates, FAQs, and other notifications which may require that you update your software to accommodate published changes. Please visit: nyhipaadesk.com.

Please contact the eMedNY Call Center for enrollment information. The contact telephone number is 800-343-9000. You will need to choose the option for enrollment.

Warning: As per the Health Insurance Portability and Accountability Act (HIPAA), CSC is required to assign unique user ids and passwords for identifying and tracking each eMedNY user’s identity [Ref: § 164.312(a)(2)(i)]. Users that share their user id and password are in violation of the HIPAA Security Regulation. If this practice is detected, the user’s access will be revoked and other sanctions may apply.