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Provider Manuals > Information for All Providers > Information for All Providers Archive

Information for All Providers Archive

Below are the previous versions of the documents for all providers.


Introduction

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Version Manual Document Change Notes

2008 - 2

Archived November 21, 2012

Introduction (PDF 96KB)

2008 - 1

Archived June 3, 2011

Introduction (PDF 96KB)

2006 - 1

Archived July 2, 2008

Introduction (PDF 80KB)

Revisions to the Introduction Section.

2004 - 1

Archived Sep. 1, 2006

Introduction (PDF 40KB)

Revisions to the Introduction Section include replacement of 'MMIS' with 'eMedNY' and a correct address for the Medicaid Update link.

General Policy

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Version Manual Document Change Notes

2011 - 1

Archived October 25, 2011

General Policy (PDF 311KB)

2010 - 2

Archived June 3, 2011

General Policy (PDF 334KB)

2010 - 1

Archived May 20, 2010

General Policy (PDF 553KB)

2008 - 2

Archived March 4, 2010

General Policy (PDF 379KB)  

2008 - 1

Archived August 28, 2008

General Policy (PDF 368KB)

Updated with changes necessitated by NPI.

2006 - 1

Archived February 29, 2008

General Policy (PDF 247KB)

Pertinent Medicaid Update Articles from the 2007 year have been added.

2004 - 1

Archived May 26, 2006

General Policy (PDF 247KB)

Pages 12-13: Recipient co-pay information has been updated to reflect the August 1, 2005 implementation of new amounts. Pages 36-38: Information on services to children has been updated to reflect policy contained in the Early Periodic Screening Diagnostic and Treatment for Child Health Plus A (Medicaid) Provider Manual.

General Billing Guidelines

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Version Manual Document Change Notes

2013 - 2 (6/28/13)

Archived October 15, 2015

General Billing Guidelines Institutional (PDF 336KB)  

2011 - 2 (12/23/11)

Archived July 1, 2013

General Billing Guidelines Institutional (PDF 634KB)  

2011 - 1 (06/01/11)

Archived July 1, 2013

General Billing Guidelines Professional (PDF 2.9MB)  

2011 - 1 (06/01/11)

Archived October 22, 2012

General Remittance Guidelines (PDF 2.78MB)  

2011 - 1 (06/01/11)

Archived January 11, 2012

General Billing Guidelines Institutional (PDF 629KB)  

General Billing

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Version Manual Document Change Notes

2014 - 1

Archived October 23, 2014

General Billing (PDF 70KB)

2013 - 1

Archived October 6, 2014

General Billing (PDF 67KB)  

2011 - 3

Archived arch 18, 2013

General Billing (PDF 105KB)  

2011 - 2

Archived July 19, 2011

General Billing (PDF 51KB)  

2011 - 1

Archived June 3, 2011

General Billing (PDF 91KB)  

2008 - 4

Archived January 6, 2011

General Billing (PDF 96KB)  

2008 - 3

Archived December 29, 2008

General Billing (PDF 96KB)  

2008 - 2

Archived August 28, 2008

General Billing (PDF 96KB)

Updated with changes necessitated by NPI.

2008 - 1

Archived July 2, 2008

General Billing (PDF 96KB)

This section has been updated semantically to change references from MMIS Provider ID to Provider ID.

2007 - 1

Archived Feb. 29, 2008

General Billing (PDF 96KB)

Pertinent Medicaid Update Articles from the 2007 year have been added.

2005 - 2

Archived Nov. 30, 2007

General Billing (PDF 163KB)

The Information for All Providers - General Billing Manual has been updated to include Medicaid Update articles from 2007.

2004 - 1

Archived Dec. 22, 2005

General Billing (PDF 53KB)

The General Billing Section has been updated to reflect changes made due to the full implementation of eMedNY. Particularly, the references to magnetic media submission have been deleted, since eMedNY does not accept magnetic media transmissions.

Inquiry

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Version Manual Document Change Notes

2011 - 1

Archived March 26, 2012

Inquiry (PDF 149KB)  

2008 - 4

Archived October 25, 2011

Inquiry (PDF 117KB)  

2008 - 3 September

Archived October 27, 2008

Inquiry (PDF 243KB)  

2008 - 3 July

Archived August 28, 2008

Inquiry (PDF 106KB)

Updated with changes necessitated by NPI.

2008 - 2

Archived July 2, 2008

Inquiry (PDF 103KB)  

2008 - 1

Archived March 28, 2008

Inquiry (PDF 104KB)

Changes were made to include the PO boxes from the April 2008 Medicaid Update.

2005 - 2

Archived January 25, 2008

Inquiry (PDF 108KB)  

2005 - 1

Archived Dec. 22, 2005

Inquiry (PDF 165KB)

The Inquiry section has updated information on seeking prior approval for orthodontia services. This information was already published in the recent Medicaid Update articles.

2004 - 1

Archived May 5, 2005

Inquiry (PDF 165KB)

Due to the change to eMedNY, this section was updated to reflect changes in telephone numbers and mailing addresses.

 

Managed Care Information

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Version Manual Document Change Notes

2016 - 1

Archived March 3, 2016

Managed Care (PDF 125KB)  

2013 - 5

Archived January 19, 2016

Managed Care (PDF 457KB)  

2013 - 4

Archived September 19, 2013

Managed Care (PDF 77KB) The Village Senior Services Corporation Managed Care plan has been added

2013 - 3

Archived August 27, 2013

Managed Care (PDF 263KB)  

2013 - 2

Archived June 18, 2013

Managed Care (PDF 77KB)  

2013 - 1

Archived February 22, 2013

Managed Care (PDF 74KB)  

2012 - 6

Archived January 2, 2013

Managed Care (PDF 77KB)  

2012 - 5

Archived December 17, 2012

Managed Care (PDF 78KB)  

2012 - 4

Archived November 13, 2012

Managed Care (PDF 77KB)  

2012 - 3

Archived October 15, 2012

Managed Care (PDF 77KB)  

2012 - 2

Archived August 31, 2012

Managed Care (PDF 79KB)  

2012 - 1

Archived March 26, 2012

Managed Care (PDF 80KB)  

2011 - 5

Archived February 17, 2012

Managed Care (PDF 80KB)  

2011 - 4

Archived November 23, 2011

Managed Care (PDF 76KB)  

2011 - 3

Archived August 18, 2011

Managed Care (PDF 80KB)  

2011 - 2

Archived May 9, 2011

Managed Care (PDF 75KB)  

2011 - 1

Archived March 8, 2011

Managed Care (PDF 80KB)  

2010 - 3

Archived January 12, 2011

Managed Care (PDF 113KB)  

2010 - 2

Archived June 10, 2010

Managed Care (PDF 116KB)  

2010 - 1

Archived April 12, 2010

Managed Care (PDF 116KB)  

Third Party Information

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Version Manual Document Change Notes

2009 - 5

Archived March 25, 2010

Third Party (PDF 232KB)  

2009 - 4

Archived December 10, 2009

Third Party (PDF 1.19MB)  

2009 - 3

Archived September 3, 2009

Third Party (PDF 374KB)  

2009 - 3

Archived July 2, 2009

Third Party (PDF 215KB)  

2009 - 3

Archived June 16, 2009

Third Party (PDF 224KB)  

2009 - 3

Archived May 11, 2009

Third Party (PDF 295KB)  

2009 - 3

Archived May 4, 2009

Third Party (PDF 170KB)  

2009 - 2

Archived April 9, 2009

Third Party (PDF 165KB)  

2009 - 2

Archived March 12, 2009

Third Party (PDF 168KB)  

2009 - 1

Archived March 2, 2009

Third Party (PDF 70KB)  

2008 - 9

Archived February 9, 2009

Third Party (PDF 63KB)

 

2008 - 8

Archived October 27, 2008

Third Party (PDF 160KB)  

2008 - 7

Archived October 2, 2008

Third Party (PDF 164KB)

 

2008 - 6

Archived August 28, 2008

Third Party (PDF 64KB) Updated with changes necessitated by NPI.

2008 - 5

Archived July 2, 2008

Third Party (PDF 58KB)

 

2008 - 4

Archived June 13, 2008

Third Party (PDF 58KB)

2008 - 3

Archived March 21, 2008

Third Party (PDF 56KB)

 

2008 - 2

Archived February 29, 2008

Third Party (PDF 60KB)

Pertinent Medicaid Update Articles from the 2007 year have been added.

2008 - 1

Archived January 25, 2008

Third Party (PDF 60KB)

Updated contact information for a PCP on page 10.

2007 - 6

Archived January 11, 2008

Third Party (PDF 60KB)

 

2007 - 5

Archived November 14, 2007

Third Party (PDF 200KB)

 

2007 - 3

Archived August 22, 2007

Third Party (PDF 150KB)

Changed all occurrences of EMEVS to MEVS.

2007 - 1

Archived May 2, 2007

Third Party (PDF 61KB)

The revised manual contains code changes and additions. Specifically:

  • WT - from "Wellcare of NY" to "Wellcare"
  • WF - from "Wausau Benefits" to "Fiserv"
  • PW - Premera Blue Cross of Washington
  • S1 - BC/BS of South Carolina

2006 - 4 (10/20/06)

Archived January 17, 2007

Third Party (PDF 61KB)

The description of code IB has been changed to "Genworth Financial" and

Duplicate insurance codes have been eliminated by TPR staff:

  • U3 Upstate Administrative Services has been changed to MH Upstate Administrative Services
  • J6 Unicare and JC John Hancock have been changed to MC Unicare
  • M9 United Health Care and MA Metra Health have been changed to F7 United Health Care

2006 - 3

Archived November 8, 2006

Third Party (PDF 134KB)

Several duplicate insurance codes have been eliminated by TPR staff:

  • EZ Empire Plan BC has been changed to 12 BC/BS Empire
  • DM Blue Choice - Medicare Risk has been changed to B7 Blue Choice Preferred
  • EL BS Northeastern NY Senior Blue has been changed to BH BS Northeastern NY
  • CI Colonial Penn Ins. Co. has been changed to CB Colonial Penn Franklin Ins Co.
  • GI General Insurance Exchange Agency has been changed to: GI Assure Care
  • P7 Humana Dental Plan, P8 Humana Healthcare Plan and P9 Humana Insurance have been changed to P6 Humana
  • F4 Independent Health Assoc Inc ( Buffalo), KL Independent Health Encompass 65 Medicare Risk ( Buffalo) have been changed to IF Independent Health Assoc Inc.
  • P4 Preferred Care Medicare Risk has been changed to PR Preferred Care
  • M2 Magna Care has been changed to HG Magna Care

New codes added:

  • CF BC/BS California
  • E7 BC/BS HMSA

2006 - 2

Archived July 12, 2006

Third Party (PDF 75KB)

The June 30, 2006 version reflects changes to Insurance Coverage Codes.

 

2006 - 1

Archived April 14, 2006

Third Party (PDF 75KB)

Third party insurance closed table has been updated. New codes have been added.

2005 - 2

Archived February 15, 2006

Third Party (PDF 76KB)

 

2004 - 1

Archived December 22, 2005

Third Party (PDF 38KB)

The Third Party section has updated codes for third party insurance coverage, along with new telephone contact numbers for prepaid capitation plans.

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