Revalidation > 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.)
Display FAQs By Any Method Below
Category:
Search:
FAQ ID:
Q.
My practice/business/institution is currently enrolled in Medicare. Do I need still need to pay an application fee to NY Medicaid?
Category: Fee
|
Published: 7/18/2016
Updated: 7/18/2016
QID: R1
A.
No. If you are already enrolled in Medicare you must complete the Application Fee Exemption Form (EMEDNY-520101) and mail it in with your Application.
I already submitted a yearly certification statement for billing. Does this mean I am revalidated?
Category: General
Published: 2/17/2016
Updated: 2/17/2016
QID: R2
NO. The annual certification statement is related to claims processing. This annual certification does not replace the revalidation process.
I am currently actively enrolled in NYS Medicaid. Do I still need to revalidate?
Updated: 3/4/2016
QID: R3
YES. All provider types must revalidate their enrollment every five years
My provider type requires an application fee to revalidate. Will my application fee be refunded if I get denied?
QID: R4
NO. The application fee is for processing purposes and will not be refunded.
If I have more than one Provider Identification Number (PID), do I pay multiple fees?
QID: R5
YES. For every PID number, a non-refundable application fee is required.
What is the application fee amount and to whom should the check/money order be payable?
Updated: 1/10/2023
QID: R6
The application fee is $709.00 (effective 01/01/2024). Please make the check payable to the NYS Department of Health. Remember to include your NPI or FEIN/Taxpayer ID on the check.
If I have been closed either by voluntary means or no billing within 2 years, can I still revalidate?
QID: R7
NO. Revalidation is for enrolled providers. However, you can reactivate your enrollment. Visit the Provider Enrollment webpage at www.eMedNY.org and complete the appropriate enrollment form. Choose the Reinstatement/Reactivation box at the top of the form.
My business is an ambulance and an Ambulette service. Each has its own PID number. Does this require two revalidation applications?
Category: Other
QID: R8
YES. An application must be completed for each PID number. The fee must be paid for each application.
If I can't pay the fee, what is needed to submit a hardship case?
QID: R9
Click here for information on how to submit a hardship exception.
Requests for hardship waiver should be sent with your enrollment form and should explain the hardship and justify the waiver, including explaining how your enrollment will ensure beneficiary access to services and supplying relevant business records. New York Medicaid will send your request to the Centers for Medicare & Medicaid Services (CMS) for review pursuant to Section 1866(j)(2)(C)(ii) of the Social Security Act.
My practice/business/institution has recently paid Medicare the application fee. Do I still need to pay an application fee to NY Medicaid?
QID: R10
If you have paid the fee to Medicare or another state's Medicaid program you may be exempt from paying the fee. Please submit the Application Fee Exemption Form (EMEDNY-520101) along with your application instead of paying the application fee.
What professions must revalidate?
QID: R11
All professions must revalidate.
What happens if I don't revalidate with NY Medicaid?
QID: R12
Federal regulations require that your enrollment be terminated. This means that you will no longer be eligible to order/refer/ prescribe services and payment for services you render will no longer be available.
If new information is issued about the revalidation process, how can I make sure I am aware of it?
Category: Communications
QID: R13
Visit our website (www.eMedNY.org), choose the Provider Enrollment tab, and then choose Revalidation Information. Also, new information is provided in the Medicaid Update, the monthly newsletter issued by the Medicaid Program. Click here for previous issues. Medicaid will also share information via the eMedNY LISTSERV®. Click here to subscribe and add your e-mail address to the LISTSERV®.
Our entity successfully revalidated a few months ago. We now need to make changes to the enrollment profile. How do I do that? What forms do I use?
QID: R14
Click here for information on how to update your enrollment file. For further information, please call eMedNY at (800)343-9000. Monday through Friday, 7:30am to 6pm.
I submitted my enrollment form and want to verify it was received. Who do I contact and what do I need when I call?
Category: Form Completion
QID: R15
Applicants may call eMedNY at (800)343-9000 to confirm their application was received. Please allow two weeks before calling to allow for mailing time, review of completeness, and entry into the enrollment system. Please have your NPI number (if you have one) and SSN or FEIN available when you call.
I submitted my enrollment form. How will I know I sent in the correct documents?
QID: R16
Provider Enrollment staff will screen the application for completeness. If one of the sections is incomplete or the required documents are not included, the entire package will be returned within several days. If there is a question about your revalidation package, staff of the Bureau of Provider Enrollment, Office of Health Insurance Programs, will contact you.
When and how will I know the Revalidation process is complete?
QID: R17
Providers who are successfully revalidated will receive a letter via US mail.
To ensure my enrollment form can be processed expeditiously, what should I be aware of when completing the form?
QID: R18
Please be sure to follow the Instructions which accompany the enrollment form. Many applicants fail to complete all required fields which results in their enrollment form being returned. ALL fields must be completed UNLESS otherwise instructed.
*** Although rare, if your situation is such that there are NO managing employees to report in Section 5 , indicate "None" in the "Name" field in the first block.
When reporting managing employees, you MUST provide their home address, SSN, date of birth and their Association type (see instructions).
Our board members refuse to provide their social security number. Will our revalidation be processed without this information?
QID: R19
All agents, managing employees and those with a control interest must provide all information requested on the form, including social security numbers. Medicaid is required to collect this information per Federal regulations. Failure to provider this information will result in the return of your application and, therefore, termination of your enrollment.
When we revalidate, do we also need to resubmit the EFT and ERA forms?
QID: R20
NO. If you are already actively enrolled and your EFT (Electronic Funds Transfer) and ERA (Electronic Remittance Advice) are active there is no need to resubmit these forms.
Our durable medical equipment business was once enrolled in Medicare. We are no longer enrolled in Medicare. Does Medicaid require Medicare participation to revalidate?
QID: R21
YES. Durable Medical Equipment providers must be enrolled in Medicare to revalidate with NYS Medicaid. The enrollment/revalidation instructions indicate whether Medicare enrollment is required. Other provider types required to be enrolled in Medicare include: clinics, chiropractors, clinical social workers, hospitals, home health agencies, hospice providers, laboratories, long term health care programs, nursing homes, OMH residential treatment facilities and community residences, pharmacies, NHTD providers, podiatrists, portable x-ray providers, physical therapists and ambulance providers.
I submitted my revalidation application and contacted eMedNY 7-10 days later to verify my application is in process. What's my next step?
Published: 3/1/2016
QID: R22
You may continue to submit claims. There is nothing more you need to do. DOH will contact you if they need more information.
Why did I receive my revalidation application back in the mail?
Updated: 3/1/2016
QID: R23
eMedNY prescreens the application for completeness and that all required documentation is present. If not complete or if there is missing (but required) documentation, the revalidation application is returned to the provider with a "Checklist" detailing what is needed for resubmission.
I recently received a notice that my enrollment has been terminated because I did not revalidate. How do I become an active Medicaid provider again?
Category: Terminations
Published: 3/4/2016
QID: R24
I am a Practitioner affiliated with more than 1 group. Do I complete a revalidation form for each group I am affiliated with?
Category: General, Form Completion
QID: R25
Complete only ONE revalidation form. Complete a Group Affiliation form #610202 for each group not listed on page 2 of the enrollment form.
I recently received a notice that my enrollment has been terminated because I did not complete the revalidation process. How do I reactivate my enrollment?
QID: R26
Send in the required/missing information for your provider type and contact the provider mailbox at providerenrollment@health.ny.gov. You must provide your Enrollment Tracking Number (ETN). Only with the missing information and your ETN will we reactivate your enrollment. You can obtain the ETN from the eMedNY Call Center at (800) 343-9000
Over three months ago I received a letter saying my enrollment was terminated because I did not revalidate my enrollment. Can I be reactivated now?
QID: R27
YES. Visit the Provider Enrollment webpage and complete the appropriate enrollment form. Choose the Reinstatement/Reactivation Box at the top of the form.
Does an Application fee apply to me?
Published: 3/11/2016
Updated: 3/11/2016
QID: R28
To determine whether you are required to pay an application fee, review the enrollment instructions appropriate for your provider type. Look in "Additional Requirements." If you see "42 CFR, Part 455.460" listed in your Instruction form, then it applies. For more information Click Here
How do I fill out the Disclosure of Ownership Section of the Enrollment / Revalidation form.
QID: R29
Read all instructions carefully, Click here for more information. Please be aware that a person can own part of an entity, but an entity can not own part of a person. If no more information can be supplied in sections 2 - 4 record 'N/A' in Box 1, in Section 5 record 'None' in Box 1.
