Updated Dental Provider Manual Documents.
The following manuals has been updated. Please see:

• Dental Policy and Procedure Manual
• Dental Fee Schedule

The following Provider Enrollment form instructions were updated:

• Ambulance
• Group
• Nurse Registry
• Optical Establishment
• Portable X-Ray
• Transportation

The following manual has been updated. Please see:

• Information for All Providers-Managed Care Information

New Provider Communications. Please see:

• Midwife
• Nurse Practitioner
• Ordered Ambulatory
• Physician

The following has been updated for Inpatient. The last page of the manual indicates the change to this new version. Please see:

• Policy Guidelines

The Managed Care Manual was updated to include information for AgeWell New York LLC and United Healthcare Personal Assist. Please see:

• Information for All Providers-Managed Care Information

The following manual has been updated. Changes were made to the WellCare of New York Managed Care plan phone number. Please see:

• Information for All Providers-Managed Care Information

New Provider Communications. Please see:

• DME

The following has been updated. Please see:

• Electronic Funds Transfer (EFT) Application Form

The following Provider Enrollment form instructions were updated:

• Group
• Optometrist
• Personal Care Agency (PCA)
• Service Bureau

The following manual has been updated. Additional Managed Care Plans were added. Please see:

• Information for All Providers-Managed Care Information

New Provider Communication. Please see:

• Physician

New Provider Communications. Please see:

• DME

New Provider Communications. Please see:

• DME
• Pharmacy

New Provider Communication. Please see:

• Dental

New Provider Communication. Please see:

• Private Duty Nursing

Effective today Medicaid enrolled prescribers can initiate prior authorization (PA) requests using a web-based application maintained by Health Information Design (HID). * This PA request/response application is accessible through a new button "PAXpress" located on the eMedNY.org homepage under the MEIPASS button. Please see:

• Clinic
• Nurse Midwife
• Nurse Practitioner
• Physician

The following Provider Maintenance form was updated:

• Address Change Form (Rate Based)

New Provider Communication. See the following link for updated information on changes to the Dental place of service payment methodology and prior approval requirements for dentures and orthodontia treatment.

• Changes in Fee for Service (FFS) Dental Place of Service (POS) Payment Methodology and Prior Approval (PA)

The following manual has been updated. Changes were made to several Managed Care plan phone numbers. Please see:

• Information for All Providers – Managed Care Information

The following has been updated. Please see:

• Electronic Funds Transfer (EFT) Application Form

Modifications have been made to the following:

• MEVS / DVS Provider Manual
• ProDUR-ECCA D.0 Provider Manual

New versions of the Electronic Funds Transfer Application have been posted to the website. In addition the Electronic Remittance Request form and the PDF Paper Remittance Request form have been combined into one request form.

The following Provider Maintenance form was updated:

• Trading Partner Agreement

The following has been updated. Please see:

• Prior Approval Roster Request Form

The following has been updated under ePACES Reference Sheets. Please see:

• ePACES PA/DVS Revise Cancel Quick Reference Guide

The following have been updated for Transportation. Please see:

• Policy Guidelines
• Ordering Guidelines for Medical Providers Located in Brooklyn & Queens
• Transportation Contact List

The following 2012 Fee Schedule has been updated:

• Transportation Fee Schedule

The following manual has been updated. Please see:

• eMedNY Submitter Dashboard User Manual

MEDS III Data Dictionary (NOT EFFECTIVE UNTIL SEPT. 2012) added for:

• Managed Care

The following Provider Enrollment Packet was updated:

• DME

A new version of the Edit Error Knowledge Base (EEKB) has been posted to the eMedNYHIPAASupport area of this website to assist providers with understanding why a claim denied or pended and the related resolution.

New Provider Communications. Please see:

• Transportation

The following 2012 Fee Schedule & Procedure Codes have been updated:

• DME Fee Schedule
• DME Procedure Codes

The following manuals have been updated. For the Managed Care Manual, ElderPlan has been changed to ElderServe and the plan's phone number has changed. For the Inquiry Manual, the Name Search Information has been removed as this service is no longer available. Please see:

• Information for All Providers – Managed Care Information
• Information for All Providers – Inquiry

DOH has created a new transportation provider manual specific to Brooklyn-based medical practitioners who will begin requesting transportation on
May 1, 2012. Please see:

• Brooklyn-Based Medical Practitioner & Facility Prior Authorization Guidelines

Modifications have been made to the MEVS / DVS Provider Manual [Version 4.4] as follows:

• 3.3 Telephone Verification Response Section
  Modified Message Sequence for Member's Medicaid Coverage to include:
  Eligible PCP with Pharmacy Carve out
  Eligible PCP with Behavioral Health Services and Pharmacy Carve Out
  Family Health Plus with Pharmacy Carve Out

• 6.1 Eligibility Benefit Descriptions
  Modified benefit Plan and Medicaid Covered Services for Eligible PCP and Family Health Plus
  MEVS / DVS Provider Manual

A new section has been added to the website called Web Services (see Self Help). At the current time this is comprised of SOAP (Simple Access Object Protocol) information. Please see the new SOAP Web Services page as well as the 4 new manuals:

• eMedNY X509 Certificate Request User Guide
• Key and Certificate Management User Guide
• eMedNY File Transfer Service User Guide
• eMedNY Meds History Service User Guide

MEDS II Data Element Dictionary updated for:

• Managed Care

Modifications have been made to the MEVS / DVS Provider Manual [Version 4.3] as follows:

• 1.0 Introduction to NYS MEVS-DVS
  Modified to include information about Speech, Occupational, and Physical Therapy under DVS
• 3.0 Introduction to Telephone (ARU) Verification Section
  Removed information about the ARU back-up number
• 4.2.2 Instructions for Completing Tran Type 4
  Modified heading to include Speech Therapy, Occupational Therapy and Physical Therapy
• 4.2.3 Instructions for Completing Tran Type 6
  Added DVS instructions for Speech Therapy, Occupational Therapy and Physical Therapy
• 5.1 Fields on eMedNY Eligibility Receipt
  Moved 'CNTY CD=' into the MSG Label
• MEVS / DVS Provider Manual

Effective February 23, 2012, Occupational, Physical and Speech Therapists will be required to obtain a DVS to provide services to Medicaid clients. A reference sheet is available on the ePACES Self Help page to assist these providers with requesting a DVS through ePACES. Please see the Obtaining a DVS for Occupational, Physical and Speech Therapy in ePACES:

• ePACES Reference Sheets

The following 2012 Fee Schedule has been added. Please see:

• Transportation 2012 Fee Schedule

Effective January 26, 2012, a new function will be added to ePACES that will allow you to revise or cancel existing prior approvals and/or DVS requests. A reference sheet detailing the new function is available on the ePACES Self Help page. Please see the ePACES PA/DVS Revise/Cancel Function:

• ePACES Reference Sheets

New Provider Communications. Please see:

• Inpatient
• Physician

The following 2012 Fee Schedules have been updated:

• Ordered Ambulatory 2012 Fee Schedule
• Physician Medicine 2012 Fee Schedule
• Physician Surgery 2012 Fee Schedule

The Out of State Non-Specialized Skilled Nursing Facility Prior Authorization Information document and form have been updated. Please see:

• Residential Health

The following manual has been updated. Please note that DOH has added a modification tracking list to track changes made to the document. (Modification tracking appears on the last page.) Please see:

• Inpatient Billing Guidelines

The Personal Care manual has been revised and renamed to include the Consumer Directed Personal Assistance Program. Please see:

• Personal Care and Consumer Directed Personal Assistance Program
• Personal Care and CDPAP Billing Guidelines