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Medicaid Managed Care Provider Enrollment Questions



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Q.

How do I confirm I am actively enrolled in NYS Medicaid?

 

 

Category: General

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 01

 
 

Q.

I am not actively enrolled in NYS Medicaid. Where should I go for more information?

 

 

Category: General, Form Completion, Communications, MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 02

 
 

Q.

I am already actively enrolled as a NYS Medicaid fee-for-service provider. Do I have to submit another application?

 

 

Category: General

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 03

 
 

Q.

If I was previously enrolled in NYS Medicaid and am no longer actively enrolled, may I keep my original Provider Identification number (PID), also known as MMIS ID?

 

 

Category: General, Form Completion

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 04

 
 

Q.

If I am a practitioner and do not wish to enroll as a NYS Medicaid fee-for-service billing provider, is there another option?

 

 

Category: General, Form Completion

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 05

 
 

Q.

If I am an organization (e.g., business, group practice, institution) and do not wish to enroll as a NYS Medicaid fee-for-service billing provider, is there another option?

 

 

Category: General, Form Completion

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 06

 
 

Q.

Am I required to accept Medicaid fee-for-service patients when I become enrolled with NYS Medicaid?

 

 

Category: General

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 07

 
 

Q.

Why did I receive my application back in the mail?

 

 

Category: Form Completion

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 08

 
 

Q.

Our board member(s) refuse to provide their social security number. Will our enrollment be processed without this information?

 

 

Category: Form Completion

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 09

 
 

Q.

The instructions indicate an application fee is required for my category of service. Why do we have to pay the fee, what is the application fee amount, and to whom should the check/money order be payable?

 

 

Category: Fee

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 10

 
 

Q.

If I can’t pay the fee, what is needed to request a hardship waiver?

 

 

Category: Fee

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 11

 
 

Q.

How will providers be notified that they are required to enroll in NYS Medicaid?

 

 

Category: Communications

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 12

 
 

Q.

May Managed Care Organziations change the sample provider outreach letter to make it plan appropriate? (i.e. MLTC instead of MMC)

 

 

Category: MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 13

 
 

Q.

Is there a way to prevent providers, who contract with multiple Managed Care Organizations, from receiving multiple notices?

 

 

Category: MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 14

 
 

Q.

Is there a list of provider types that are exempt from enrollment?

 

 

Category: Communications, MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 15

 
 

Q.

Will a list of enrolled providers be given to the Managed Care Organizations?

 

 

Category: MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 16

 
 

Q.

Will the State be providing a copy of the August 30, 2017 PowerPoint presentation?

 

 

Category: General, MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 17

 
 

Q.

Why am I required to enroll in NYS Medicaid if I am a Managed Care provider?

 

 

Category: General, Communications, MCO Communication

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 18

 
 

Q.

Are non-emergency transportation providers required to enroll?

 

 

Category: Other

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Published: 10/4/2017

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Updated: 10/4/2017

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QID: 19

 
 

Q.

Is the FFS active provider list the same file that is downloaded from PNDS? File name = "MMIS Validation".

 

 

Category: MCO Communication

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Published: 12/5/2017

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Updated: 12/5/2017

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QID: 20

 
 

Q.

Does the FFS active provider list include providers who are sanctioned by Medicaid?

 

 

Category: General, MCO Communication

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Published: 12/5/2017

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Updated: 12/5/2017

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QID: 21

 
 

Q.

Can the FFS active file be updated daily as there may be issues with claims pending without daily feeds?

 

 

Category: Communications, Managed Care Network Eligibility

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Published: 12/5/2017

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Updated: 12/5/2017

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QID: 22

 
 

Q.

If we contract with a business that provides nursing services, do the individual practitioners /nurses need to enroll as well as the business?

 

 

Category: Other

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Published: 12/5/2017

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Updated: 12/5/2017

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QID: 23

 
 

Q.

I am required to be enrolled in Medicare as a prerequisite to enroll with NYS Medicaid but I opted out of Medicare a year ago and cannot enroll with them for another year. What should I do?

 

 

Category: General, Form Completion, Communications, MCO Communication

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Published: 12/5/2017

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Updated: 12/5/2017

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QID: 24