December 23, 2025Attention: It's almost time for HealthHelp's Provider Satisfaction Survey
HealthHelp's Provider Satisfaction Survey is going out to providers and facilities beginning December 29, 2025, for two weeks.
As a user of Consult, specialty benefits management services administered by HealthHelp, your feedback is vital for improving our processes. HealthHelp provides easy ways for you to obtain authorizations: through our online web application, phone authorization through our call center, and IVR automated touch phone system. We would like your input on any of the methods you have used to contact HealthHelp.
Please participate to help us improve our processes with your feedback. The survey takes about five minutes to complete. We are offering three $100 Amazon gift cards in appreciation for participation. Winners will be randomly selected from the respondents who provide a valid email address. Please help us make the most of this opportunity by encouraging participation that helps us improve the provider experience!
Visit HealthHelp.com/Survey The survey link will be active beginning on December
29th. We look forward to hearing from you!
- December 12, 2025
Attention: Edit 02304 – Zero-Fill for Private Duty Nursing (PDN) Claims
Effective 1/1/2026, all new bypasses of Edit 02304 for PDN services, approval for the zero-fill bypass, will be valid for three years. Please see communication for further details.
- December 1, 2025
Attention: 2026 NYS MEDICAID DENTAL POLICY AND PROCEDURE CODE MANUAL AND UPDATED FEE SCHEDULE
The 2026 Dental Policy and Procedure Codes Manual and Fee Schedule have been posted. Changes reflected in the manual are effective for dates of service beginning January 1, 2026. Questions related to manual and fee schedule updates can be directed to the Bureau of Dental Review at dentalpolicy@health.ny.gov, or (800) 342-3005, Option 2. Billing related questions can be directed to GDIT at (800) 343-9000.
Click Here for the Dental Manual Page
- November 26, 2025
Attention: Backup Power Wheelchair Repairs
Effective January 1, 2026 for Fee-for-Service (FFS) and March 1, 2026 for Managed Care, in limited instances, Group 2, Group 3, Group 4, Group 5, and Group 6 power wheelchairs (PWC) with or without power options, will be eligible for use as a backup power wheelchair when the user has been provided with a new, primary PWC. This backup PWC will allow the member to maintain independent mobility when the primary PWC is being repaired or when a backup manual wheelchair or suitable loaner wheelchair that would meet the member’s medical needs cannot be provided.
Please see communication for additional information.
- November 26, 2025
Attention: Preventative Maintenance for Power Wheelchairs
Effective January 1, 2026 for Fee-for-Service (FFS), and March 1, 2026 for Managed Care, preventative maintenance will be covered for all primary power wheelchairs (PWC) that are less than 5 years old.
Please see communication for additional information.
- October 24, 2025
Attention: Effective November 3, 2025, Clinic Claims setting Edit 02166 will pend to the Department of Health for manual review
Effective November 3, 2025, Clinic claims setting edit 02166 – Delay reason code 11 invalid will pend to the Department of Health (DOH) for manual review. The corresponding HIPAA codes that will be reported on the 835 remittances are Claim Adjustment Reason Code 29 and Remittance Remark Code N892. While the claim(s) is pending review, the corresponding claim status response code will be 718.
Please see communication for additional information.
Complete the EFT Form
