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Revalidation > Frequently Asked Questions

Frequently Asked Questions (FAQs) for Revalidation

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Q.

Does an application fee apply to me?

 

 

Category: Fee

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Published: 3/11/2016

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Updated: 9/11/2024

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QID: R28

 
 

A.

On the eMedNY.org enrollment page for your category of service, look under Requirements & Additional Forms to determine if an application fee is applicable to your category of service.

 
 

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

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Published: 7/18/2016

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Updated: 7/18/2016

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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.

 
 

Q.

I already submitted a yearly certification statement for billing. Does this mean I am revalidated?

 

 

Category: General

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R2

 
 

A.

NO. The annual certification statement is related to claims processing. This annual certification does not replace the revalidation process.

 
 

Q.

I am currently actively enrolled in NYS Medicaid. Do I still need to revalidate?

 

 

Category: General

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R3

 
 

A.

YES. All provider types must revalidate their enrollment when notified to do so. This generally occurs every five years but, at the Department's discretion, may also be requested at any time.

 
 

Q.

My provider type requires an application fee to revalidate. Will my application fee be refunded if I get denied?

 

 

Category: Fee

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R4

 
 

A.

NO. The application fee covers the cost of required screening and cannot be refunded for a denied enrollment.

 
 

Q.

If I have more than one Provider Identification Number (PID), do I pay multiple fees?

 

 

Category: Fee

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R5

 
 

A.

YES. Every Provider Identification Number (PID) is considered a separate enrollment. Therefore, an application fee would be required for each PID when at least one category of service (COS) on the PID requires an application fee.

 
 

Q.

What is the application fee amount and to whom should the check/money order be payable?

 

 

Category: Fee

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Published: 2/17/2016

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Updated: 12/31/2024

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QID: R6

 
 

A.

The application fee is $730.00 (effective 01/01/2025). Please make the check payable to the NYS Department of Health. Remember to include your NPI or FEIN/Taxpayer ID on the check.

 
 

Q.

If my enrollment has been voluntarily or involuntarily terminated, can I still revalidate?

 

 

Category: General

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R7

 
 

A.

NO. Revalidation is for actively enrolled providers. If a provider wishes to reactivate an enrollment that has been terminated, they must submit an application marked for reinstatement.

 
 

Q.

My business is an ambulance and an Ambulette service. Each has its own PID number. Does this require two revalidation applications?

 

 

Category: Other

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R8

 
 

A.

YES. An application must be completed for each PID number. The fee must be paid for each application.

 
 

Q.

If I can't pay the fee, what is needed to submit a hardship case?

 

 

Category: Fee

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R9

 
 

A.

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.

 
 

Q.

My practice/business/institution has recently paid an application fee to Medicare. Do I still need to pay an application fee to New York State Medicaid?

 

 

Category: Fee

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R10

 
 

A.

You may be exempt from paying an application fee to New York State Medicaid if you have recently paid an application fee to Medicare or another state's Medicaid program. To apply for such an exemption, please submit the Application Fee Exemption Form (EMEDNY-520101) along with your application for revalidation instead of the application fee.

 
 

Q.

What professions must revalidate?

 

 

Category: General

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R11

 
 

A.

All professions must revalidate.

 
 

Q.

What happens if I don't revalidate with NY Medicaid?

 

 

Category: General

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R12

 
 

A.

Federal regulations require that your Medicaid enrollment be terminated if you fail to revalidate. This means you will no longer be paid for services rendered to, and/or you will no longer be eligible to order, refer, or prescribe for New York State Medicaid recipients.

 
 

Q.

If new information is issued about the revalidation process, how can I make sure I am aware of it?

 

 

Category: Communications

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R13

 
 

A.

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®.

 
 

Q.

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?

 

 

Category: General

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R14

 
 

A.

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.

 
 

Q.

I submitted my enrollment form for revalidation and want to verify it was received. How do I do that?

 

 

Category: Form Completion

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R15

 
 

A.

Providers can call eMedNY at (800) 343-9000 to confirm their enrollment form for revalidation was received. Please wait at least two weeks before calling to allow time for the postal and intake processes. Please have your NPI number, if applicable, and Social Security or FEIN number available when you call.

 
 

Q.

When and how will I know the revalidation process is complete?

 

 

Category: Communications

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R17

 
 

A.

Providers will receive a letter via U.S. mail when their enrollment form for revalidation has been successfully processed. Providers will not be terminated for failing to revalidate between the time the revalidation is submitted and the time it is processed unless they fail to respond to a subsequent request for additional information.

 
 

Q.

To ensure my enrollment form for revalidation can be processed as quickly as possible, what should I do?

 

 

Category: Form Completion

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R18

 
 

A.

Please read through the enrollment information and instructions on eMedNY for your category of service. Carefully follow the General Instructions for the Enrollment Form, Additional Instructions for the Enrollment Form, and Requirements & Additional Forms, and be sure to include all required forms.

 
 

Q.

Our board members refuse to provide their social security number. Will our revalidation be processed without this information?

 

 

Category: Form Completion

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R19

 
 

A.

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.

 
 

Q.

When we revalidate, do we also need to resubmit the EFT and ERA forms?

 

 

Category: Form Completion

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Published: 2/17/2016

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Updated: 2/17/2016

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QID: R20

 
 

A.

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.

 
 

Q.

My provider type was required to have Medicare at enrollment. Is Medicare participation required to revalidate for Medicaid?

 

 

Category: Other

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Published: 2/17/2016

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Updated: 9/11/2024

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QID: R21

 
 

A.

Navigate to your provider type at the Medicaid Provider Index and review the Requirements & Additional Forms section. If Medicare is listed as a requirement, then it is also required at revalidation and will be verified.

 
 

Q.

I submitted my enrollment form for revalidation and contacted eMedNY 21 days later to verify my application is in process. What's my next step?

 

 

Category: Communications

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Published: 3/1/2016

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Updated: 9/11/2024

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QID: R22

 
 

A.

You may continue to submit claims. There is nothing more you need to do unless DOH contacts you.

 
 

Q.

Why did I receive my revalidation application back in the mail?

 

 

Category: Form Completion

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Published: 3/1/2016

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Updated: 3/1/2016

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QID: R23

 
 

A.

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.

 
 

Q.

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

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Published: 3/4/2016

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Updated: 9/11/2024

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QID: R24

 
 

A.

To request reinstatement more than 90 days after a termination for failing to revalidate, the provider must complete the enrollment form for their provider type, checking off the reinstatement/reactivation box toward the top, and mail to the eMedNY address on the form. If a provider is reinstated after failing to meet revalidation requiremetns, there may be a gap in enrollment.

 
 

Q.

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

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Published: 3/4/2016

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Updated: 3/4/2016

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QID: R25

 
 

A.

Complete only ONE revalidation form. Complete a Group Affiliation form #610202 for each group not listed on page 2 of the enrollment form.

 
 

Q.

How do I fill out the Disclosure of Ownership Section of the Enrollment / Revalidation form.

 

 

Category: Form Completion

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Published: 3/11/2016

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Updated: 9/11/2024

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QID: R29

 
 

A.

Read all instructions carefully.

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.

 
 

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