eMedNY : What's New : Archive : 2008

What's New > Archives > 2008

Status	Date	Page/Document	Description
New	12/31/08	Provider Manuals Update	New Provider Communications: DME Midwife Nurse Practitioner Ordered Ambulatory Physician Pharmacy
Changed	12/30/08	Provider Enrollment Forms	NYS Legislation has extended the Medically Fragile Program to December 2010. Please see new letter which precedes the form: (Note: the form remains unchanged.) Medically Fragile Children PDN Rate Enhancement
New	12/29/08	Provider Manuals Update	New Provider Communications: DME Pharmacy
Changed	12/29/08	Provider Manuals Update	An Update has been made to: Information for All Providers -General Billing
New	12/22/08	Provider Manuals Update	New Provider Communications: Physician Nurse Practitioner Rehabilitation Services
New	12/22/08	Provider Manuals Update	New Provider Communications: DME
Changed	12/18/08	Provider Manuals Update	Modifications have been made to the following: ProDUR-ECCA Provider Manual ProDUR-ECCA Standards Manual
Changed	12/11/08	Provider Manuals Update	The following Fee Schedule is a replacement: Physician Radiology
Changed	12/08/08	Provider Manuals Update	Modifications have been made to the listed billing guidelines as follows: The line that contained the 8 digit MMIS Provider ID, NPI Number and Check Issue Date that appeared above the Provider Name in the address area on the paper check sample has been removed. Assisted Living (ALP) Bridges to Health Child (Foster) Care Agency Chiropractor Clinic Clinical Psychology Clinical Social Worker Comprehensive Medicaid Case Management Day Treatment DME Dental HCBS/TBI Waiver Services Home and Community Based Services (HCBS Waiver) Hearing Aid Home Health Hospice Intermediate Care Facility Dev. Disabled (ICF/DD) Inpatient Laboratory Limited Licensed Home Care Long Term Home Healthcare Managed Care Midwife OMH Certified Rehabilitation Services Ordered Ambulatory Personal Care Personal Emergency Response System (PERS) Pharmacy Physician Podiatry Private Duty Nursing Rehabilitation Services Residential Health School Supportive Health Services Program (SSHSP) Transportation Vision Care
Changed	11/25/08	Provider Manuals Update	The following 2009 Fee Schedules and Procedure Codes sections have been updated: Clinical Psychology Procedure Codes & Fee Schedule Rehabilitation Services Procedure Codes & Fee Schedule Physician Drugs 2009 Fee Schedule Physician Medicine 2009 Fee Schedule Physician Radiology 2009 Fee Schedule Physician Surgery 2009 Fee Schedule Hearing Aid 2009 Fee Schedule Vision Care 2009 Fee Schedule Midwife 2009 Fee Schedule Nurse Practitioner 2009 Fee Schedule
New	11/21/08	Provider Enrollment Forms	New Provider Enrollment Packets: Certified Asthma Educator (CAE) Certified Diabetes Educator (CDE)
Changed	11/06/08	Provider Manuals Update	Modifications have been made to the following: MEVS Provider Manual
New	11/06/08	Provider Manuals Update	New Provider Communications: Pharmacy
New	10/30/08	Provider Manuals Update	New Provider Communications: DME
Changed	10/27/08	Provider Manuals Update	Inquiry - Information for All Providers has been updated. Please note the change to the Enrollee Eligibility Determination telephone number. Please see: Information for All Providers - Inquiry
Changed	10/27/08	Provider Manuals Update	Third Party - Information for All Providers has been updated. Please note the Code "FL: Pharmacare" has been deleted, as this is now associated with "DV: Caremark." Change the telephone number for Prepaid Capitation Plan "KX" to 212 563-5570. Update the Prepaid Capitation Plan listing with information from the Office of Managed Care dated 10/3/08. Please see: Information for All Providers - Third Party Information
Changed	10/23/08	Provider Manuals Update	MEDS II Data Element Dictionary updated for: Managed Care
Changed	10/23/08	Provider Manuals Update	Modifications have been made to the following: ProDUR-ECCA Provider Manual ProDUR-ECCA Standards Manual
Changed	10/23/08	Provider Manuals Update	The following Policy Guidelines Manual has been updated: Pharmacy Manual Policy Guidelines
New	10/20/08	Provider Manuals Update	New Provider Communications: DME
New	10/16/08	Provider Manuals Update	New Provider Communications: DME
New	10/09/08	Provider Manuals Update	New Provider Communications: DME
Changed	10/06/08	eMedNY Paper Forms	The following eMedNY Paper Forms documents have been updated with NPI information and address information: Prior Approval Change Request Form Instructions Electronic Attachment Scanning Form Instructions Threshold Override Application Form Instructions Threshold Override Application (TOA)
Changed	10/02/08	Provider Manuals Update	Modifications have been made to the following: MEVS Provider Manual
Changed	10/02/08	Provider Manuals Update	Third Party - Information for All Providers has been updated. Please note the deleted code FL:Pharmcare because it was merged with DV: Caremark. Changed the telephone number for PCP code KX. Please see: Information for All Providers - Third Party Information
Changed	09/25/08	eMedNY Paper Forms	The following eMedNY Paper Forms and Instructions have been updated with NPI information: Prior Approval Change Request Form Prior Approval Change Request Form Instructions Electronic Attachment Scanning Form Electronic Attachment Scanning Form Instructions
New	09/22/08	Provider Manuals Update	New Provider Communications: Private Duty Nursing
Changed	09/15/08	Provider Manuals Update	Modifications have been made to the following billing guide: Dental
Changed	09/08/08	eMedNY Paper Forms	The following eMedNY Paper Forms have been updated with NPI information: Order/Prior Approval Request - Pharmacy/DME, Nursing, Eye Care, Physician Order/Prior Approval Request - Dental Services Hearing Aid - Order/Prior Approval request High/Special Level of Care - Determination of Medical Eligibility Group Transportation Prior Approval
Changed	09/08/08	Provider Manuals Update	The following PA Guidelines Manual has been updated: City of New York Transportation Ordering Guidelines Manual
New	09/08/08	Provider Manuals Update	New Provider Communications: Hearing Aid
Changed	09/04/08	Provider Manuals Update	Instructions for entering Present on Admission (POA) information was added to the following Billing Guide: Inpatient
New	09/04/08	Provider Manuals Update	New Provider Communications: DME
Changed	09/04/08	Provider Manuals Update	Modifications have been made to the following billing guide: Bridges to Health
Changed	08/28/08	Provider Manuals Update	Below are the Information for All Providers Manuals and the Transportation Manual Policy Guidelines with changes necessitated by NPI: Information for All Providers - General Policy Information for All Providers - General Billing Information for All Providers - Inquiry Information for All Providers - Third Party Information Transportation Manual - Policy Guidelines
Changed	08/25/08	Provider Enrollment Forms	NPI updates were made to the Electronic Funds Transfer (EFT) Enrollment Form.
New	08/25/08	Provider Manuals Update	New Provider Communications: DME
Changed	08/21/08	Provider Enrollment Forms	Changes were made to accept Zip +4 for the following form: Fee for Service Address Change Form
Changed	08/21/08	Provider Manuals Update	NPI modifications have been made to the following: ProDUR-ECCA Provider Manual ProDUR-ECCA Standards Manual
New	08/18/08	Information	Under Notifications, please see two new Provider Letters regarding Family Health Plus Enrollees for billing requirements effective October 1st, 2008. These letters have been mailed to Pharmacy and Prescribing Providers.
Changed	08/18/08	Provider Manuals Update	Modifications have been made to the following: MEVS Provider Manual Quick Reference Cards ARU Quick Reference Cards VeriFone Omni3750
New	08/07/08	Provider Manuals Update	New Provider Communications: Physician Free Standing or Hospital Based Ordered Ambulatory
Changed	08/04/08	Provider Enrollment Forms	Changes were made to meet the requirements of 42 CFR, §455.105 to the following: Portable X-ray Enrollment Packet Physician Enrollment Packet Pharmacy Enrollment Packet Nurse Practitioner Enrollment Packet Registered Physician's Assistant Enrollment Packet LPN/RN Nursing Enrollment Packet Service Bureau Enrollment Packet Podiatrist Enrollment Packet Dentist Enrollment Packet Clinical Psychologist Enrollment Packet Clinical Social Worker Enrollment Packet Chiropractor Enrollment Packet Therapist Enrollment Packet Nurse Registry Enrollment Packet Self Employed Optician-Optometrist Enrollment Packet Hearing Aid Dealer Enrollment Packet Transportation Enrollment Packet Midwife Enrollment Packet Group Enrollment Packet DME Enrollment Packet Optical Establishment/Salaried Optician/Optometrist Enrollment Packet Laboratory Enrollment Packet
Changed	08/04/08	Provider Manuals Update	The following PA Guidelines have been updated: Dental DME Hearing Aid Physician Private Duty Nursing Vision Care
Changed	08/04/08	Provider Manuals Update	The following PA Guideline has been updated: City of New York Transportation Ordering Guidelines Manual
Changed	07/24/08	Provider Enrollment Forms	Web PDF printing instructions were added and updates were made to the Electronic/Paper Transmitter Identification Number (TSN/Provider) and Electronic Transmitter Identification Number (TSN/Service Bureau) Provider Enrollment Forms Packets.
Changed	07/24/08	Provider Manuals Update	Modifications have been made to the following billing guides: Chiropractor Clinic Clinical Psychology Clinical Social Worker DME Dental Hearing Aid Inpatient Laboratory Midwife Nurse Practitioner Ordered Ambulatory Pharmacy Physician Podiatry Private Duty Nursing Rehabilitation Services Transportation Vision Care
New	07/21/08	Provider Manuals Update	New Provider Communications: DME
New	07/11/08	Provider Manuals Update	New Provider Communications: DME Pharmacy Physician Nurse Practitioner Ordered Ambulatory
Changed	07/09/08	Provider Manuals Update	The policy on ambulance transportation to and from Regional Perinatal Centers (page 7) has been updated. Regional perinatal centers are responsible for the costs of ambulance transportation to the center. Upon discharge, the cost of ambulance transportation is fee-for-service. Policy Guidelines
Changed	07/02/08	Provider Manuals Update	New Provider Communications: DME
Changed	07/02/08	Provider Manuals Update	The following grammatical changes were made: "recipient" was changed to "enrollee" and "Office of Medicaid Management" was replaced with "Office of Health Insurance Programs" for the following: Information for All Providers - Introduction
Changed	07/02/08	Provider Manuals Update	The following have been updated semantically to change references from MMIS Provider ID to Provider ID: Information for All Providers - 3rd Party Information for All Providers - General Billing Information for All Providers - Inquiry
New	06/27/08	Provider Manuals Update	New Provider Communications: Pharmacy
Changed	06/25/08	Provider Manuals Update	The following Fee Schedule is a replacement: DME
Changed	06/20/08	Provider Manuals Update	Modifications have been made to the following billing guides: Bridges to Health CMCM HCBS HCBS-TBI Waiver Home Health LLHCSA Managed Care SSHSP
Changed	06/18/08	Self Help	The Admission Type in the ePACES Institutional Claim Reference Guide, available in the Self Help section, was updated to indicate that Outpatient claims use this field to indicate an emergency service. Please see: ePACES Institutional Claim Reference Guide
Changed	06/18/08	Provider Manuals Update	As this version of policy remains accurate, we are reposting the 2006 version of this manual: OMH Certified Rehabilitation Services Policy Guidelines
Changed	06/13/08	Information for All Providers Update	The description of insurance code "WF" has been changed from "Fiserv" to "UMR" and "J8" has been changed from "Jardine Group Services" to "JLT Services Corp". Additionally, contact information for Prepaid Capitation Plan YR has been added to the following document: Third Party Information
Changed	06/13/08	Provider Manuals Update	Modifications have been made to the following billing guides: Assisted Living Child Care Day Treatment Hospice Intermediate Care Facility Dev. Disabled Long Term Home Health Care OMH Certified Rehabilitation Services PERS Personal Care Residential Health Care
Changed	06/13/08	Provider Manuals Update	The policy section of the transportation provider manual was updated to include information about the National Provider Identification (NPI) number. Additionally, information included in recent Medicaid Updates, particularly the change if the fees paid for using a toll bridge or tunnel in New York City, was placed in the manual. Please see: Policy Guidelines
Changed	06/06/08	Provider Manuals Update	Modifications have been made to the following: MEVS Provider Manual Quick Reference Cards VeriFone Omni3750
New	06/06/08	Provider Manuals Update	New Provider Communications: DME
Changed	05/21/08	Provider Enrollment Forms	Changes were made to the Rate Based Change of Address Form. Rate Based Change of Address Form
Changed	05/21/08	Provider Manuals Update	The following Fee Schedules, Fee Schedule Column Descriptions, and Procedure Codes Sections (Section 1- General Information, Section 2 - Medicine, Section 3 - Drugs and Drug Administration, Section 4 - Radiology, and Section 5 - Surgery) have been updated effective 05/15/2008 for: Physician
Changed	05/14/08	Provider Manuals Update	The Department is including information on our "Pay and Seek" policy. In the case of certain ambulatory pregnancy-related services, and primary care provided to children, Medicaid pursues a “pay and seek” method of reimbursement. This means that you should bill Medicaid for certain diagnosis codes without first pursuing any available third party insurance. This information can be found on page 18 of this updated policy section. Policy Guidelines
Changed	04/30/08	Provider Manuals Update	The following Fee Schedule and Procedure Codes sections have been updated effective 05/01/08. DME
Changed	04/23/08	Provider Manuals Update	Modifications have been made to the following: ProDUR/ECCA Provider Manual ProDUR/ECCA Standards Manual
Changed	04/18/08	Provider Manuals Update	Modifications have been made to the following: MEVS Provider Manual
Changed	04/16/08	Provider Manuals Update	The DME Manual has been changed. The previous policy section has been removed, as it contained misinformation. The current policy section in place reverts to the previous policy section. Please see: Policy Guidelines
Changed	04/11/08	Provider Manuals Update	The following Fee Schedules and Procedure Codes sections have been updated effective for dates of service 4/1/2008 and later: Laboratory Midwife Nurse Practitioner Ordered Ambulatory Pharmacy
Changed	04/04/08	Provider Manuals Update	The Home Health Manual has been updated. A section on the home assessment requirement for prior approval of private duty nursing services has been added on pages 5-6. Please see: Policy Guidelines
New	04/02/08	Provider Manuals Update	New Provider Communications: Physician DME
Changed	03/28/08	Provider Manuals Update	Information For All Providers - Changes were made to include the PO boxes from the April 2008 Medicaid Update. Please see: Information For All Providers- Inquiry
Changed	03/21/08	Provider Manuals Update	This section was changed, starting on page 10. The 'Plan Type' has been added to each managed care plan. For example, some plans are considered 'mainstream,' while others may be 'Family Health Plus.' Information For All Providers- Third Party Information
Changed	03/12/08	Self Help	Mailing addresses for the following FAQs have been updated: BBS / Gateway Frequently Asked Questions (FAQ) FTP Frequently Asked Questions (FAQ) Electronic Funds Transfer (EFT) Frequently Asked Questions (FAQ)
New	03/07/08	Provider Manuals Update	New Provider Communications: DME
Changed	03/07/08	Provider Manuals Update	The policy section of the DME Provider Manual has been revised to include information sent to providers in different publications of the Medicaid Update during 2007. Please see : DME Provider Manual Policy Section
Changed	03/07/08	Provider Manuals Update	The following Billing Guidelines Manual has been updated: Residential Health Provider Manual Billing Guidelines
New	03/07/08	Provider Manuals	The following Policy Guidelines Manual has been added: Hospice Policy Guidelines
Changed	03/05/08	Provider Manuals Update	The following Prior Authorization Guidelines Manual has been updated: Transportation Prior Authorization Guidelines
Changed	02/29/08	Provider Enrollment Forms	P.O. boxes were added to addresses for the following: Electronic/Paper Transmitter Identification Number (TSN/Provider) Electronic Transmitter Identification Number (TSN/Service Bureau) Security Packet A Security Packet B Electronic Remittance Request Form Electronic Prior Approval Request Form Paper Remittance Sort Request Form Electronic Funds Transfer (EFT) Enrollment Form Pended Claim Recycle Request Form Request to Disaffiliate/Delete an ETIN
New	02/20/08	Provider Manuals Update	The Following Prior Approval Guidelines Manual has been added: Vision Care Prior Approval Guidelines
Changed	02/15/08	Self Help Update	Added bullet to Service line section on page 20: To indicate the NDC, Drug Unit Price and National Drug Unit Count when billing physician administered drugs in the following document: ePACES Professional Real Time Claim Reference Guide Added bullet to Service Line section on page 18: To indicate the NDC, Drug Unit Price and National Drug Unit Count when billing physician administered drugs in the following document: ePACES Professional Claim Reference Guide Added sentence to More section on page 16: These claim types should use the MORE button in order to report the Deductible, Coinsurance, the Medicare Psychiatric Reduction amounts, NDC, Drug Unit Price and/or National Drug Unit Count. NDC information will be reported for Ordered Ambulatory Providers if they are submitting physician-administered drugs in the following document: ePACES Institutional Claim Reference Guide
Changed	02/13/08	Provider Enrollment Forms Update	A check box was added (Item # 8) to allow the provider to revert back to paper prior approval determinations for the Electronic Prior Approval Request Form.
New	01/30/08	Provider Enrollment Forms	The following Provider Maintenance form has been added: Out-of-State Hospital Enrollment Package Request Form
Changed	01/25/08	Provider Manuals Update	Contact Information has been changed in the following manuals: Information For All Providers- Third Party Information Information For All Providers- Inquiry
Changed	01/23/08	Provider Manuals Update	Changes were made to the Care at Home Waiver Section on pages 9-10 of the Policy Guidelines. Please see: Private Duty Nursing
Changed	01/23/08	Provider Manuals Update	Private Duty Nursing Procedure Codes and Fee Schedule update is available, effective for dates of service 1/1/2008 and later. Private Duty Nursing
New	01/18/08	Provider Manuals Update	New Provider Communications: Pharmacy
Changed	01/11/08	Provider Manuals Update	Information For All Providers - Third Party Information has been updated to reflect changes to the Prepaid Capitation Plan codes and contact information. Additionally, a new Third Party Insurance code, 'TP' Prime Therapeutics Pharmacy has been added. Please see: Information For All Providers- Third Party Information
New	01/09/08	Provider Manuals Update	New Provider Communications: DME
Changed	01/04/08	Provider Manuals Update	The following Billing Guides and Provider Manuals have been updated Child (Foster) Care Agency Home and Community Based Services (HCBS Waiver) HCBS/TBI Waiver Services Personal Emergency Response System (PERS) An address change was made to the Stop Loss Policy and Procedures and the Provider Manual for: Managed Care