eMedNYHIPAASupport > Frequently Asked Questions
Select any of the following options to filter the list of FAQs. (Selecting no options is the same as selecting all options.)
Category:
Q.
Cycle – What is the Claims Cycle?
Category: eMedNY Processing
|
Published: 05/26/2004
Updated: 08/12/2015
QID: CP02
A.
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 the eMedNY system before 6:00 PM on Monday. eMedNY 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.
When claims (sent as X12 837) have been accepted into the eMedNY system for adjudication, a 277 Claim Acknowledgment (277CA) transaction is returned. The six digits following the "R" in the first node of the filename are the date stamp of the 277CA.
This date can be used to look up a corresponding cycle number using the Cycle Processing Calendar. Claims that were finalized at adjudication (not pended) will be reported in that cycle's remittance advice.
