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eMedNY's Headquarters for HIPAA X12 5010/NCPDP D.0

When entering this site, be sure to review eMedNYHIPAASupport What's New for the latest changes.

Important Announcements

April 30, 2018

Updates to ASC X12 834 and Supporting Documents and Managed Care Enrollment Information:

Effective immediately, the eMedNY 834 Managed Care Enrollment Companion Guide, the 834 Enrollment Information document and the 834 FAQs have been removed from the eMedNY website. New documentation will be published as they become available.

October 24, 2016

The eMedNY Transaction Information Standard Companion Guide CAQH - CORE CG X12 has been updated. This is a major revision with all information added pertinent to the X12 HIPAA transactions that was previously published in the eMedNY Transaction Information Standard Companion Guide X12 or in the eMedNY Trading Partner Information Standard Companion Guide. These two documents will be scheduled for retirement in the near future.

July 9, 2014

On July 28, 2014 eMedNY will open the Provider Testing Environment (PTE) for submitters to begin testing Medicaid claims with ICD-10 diagnosis codes. In addition inpatient hospital claims that utilize ICD-10 procedure codes may be tested beginning on this date.
Click Here to read more

March 21, 2014

Medicaid Required by Federal Law to Change Electronic Remittance Delivery Date

Effective April 7, 2014 (Cycle 1911) eMedNY will no longer be permitted to make the X12 835 and the X12 820 electronic remittances available two weeks prior to release of payment. Electronic remittances will be available two days prior to the release of funds. The change is necessitated by requirements of Section 1104 of the Affordable Care Act (ACA) and the CAQH Committee on Operating Rules for Information Exchange (CORE), the authoring entity for operating rules for Electronic Fund Transfer (EFT) and Electronic Remittance Advice (ERA) transactions. Click here to read more.

December 26, 2013

Remittance Advice will be changing: In accordance with the requirements of the Affordable Care Act's Electronic Funds Transfer provisions and mandated CAQH-CORE Operating Rule 360, NYS Medicaid will report claims adjudication system edits using a revised set of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC). Revisions to the Edit Mapping for 835 crosswalks will be posted before the first Financial Cycle of 2014, Cycle #1898.

October 31, 2013

Attention Submitters: Provide Proper EDI Contact Information to ensure that there is minimal delay if a problem is identified by eMedNY and an outbound call is necessary. Click here for details.

About eMedNYHIPAASupport

NYS Medicaid is dedicated to providing pertinent information relating to the New York State Medicaid program. All health care providers are required to submit claims electronically. This includes all health plans including private and government programs, and health care clearinghouses. We urge the health care community to become familiar with the requirements affecting eMedNY.

This site has been created for the provider community, and will be used by the NYS Medicaid program as a main source for dissemination of information and notification of all New York State Medicaid activities. This site will be updated on a regular basis in an effort to share relevant Medicaid information, its potential impact on our program and its potential impact on providers' business processes and information system. Whenever entering this site, be sure to check out our Frequently Asked Questions (FAQ's) section. We have already posted answers to many of your most common and problematic questions. We will be continuing to post new questions and answers as they arise.