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eMedNY Tools Center > Go Green

Complete one of the forms below and receive your payments and remittances more efficiently and expediently.

EFT Electronic Funds Transfer (EFT) Authorization Form

The New York State Department of Health (DOH) and their eMedNY fiscal agent are pleased to announce the availability of eMedNY Electronic Funds Transfer (EFT). Providers who enroll in EFT will have their Medicaid payments directly deposited in their checking or savings account.

The advantages to receiving EFT are:

  1. Electronic deposits directly into a checking or savings account.
  2. The deposit often occurs a day sooner than the paper check.

ERA/PDF Electronic Remittance/PDF Remittance Request Form

Electronic remits are delivered in a HIPAA compliant format and require software to interpret the information.

There are many advantages to receiving a PDF version of the paper remittance:

  1. You will know when the PDF is available in your eXchange account and not have to wait for the mail.
  2. The remittance can be downloaded and stored electronically for ease of retrieval and you can still print a hard copy.
  3. The remittance can be word searched to help locate specific claims.
  4. The PDF will look exactly like the paper remittance.
  5. Remittances can be printed with Adobe ReaderĀ® (6.0 release or higher required), which is available free of charge.

EPA Electronic Prior Approval Request Form

This application will allow you to receive the New York Medicaid Prior Approval determinations in a printable PDF format, through eMedNY eXchange.

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