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Commercial Insurance
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Medicaid Enrollment
Question Contains
Commercial Insurance
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Is there any registration with an insurance company before we start claiming?
Answer
A:
The Fiscal Agent will enroll you with a commercial insurance clearinghouse automatically. Some individual insurance companies may require a separate agreement between the provider and the insurance company directly, but many do not.
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General
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Are the municipalities still responsible for sending a copy of the authorization numbers to the agencies?
Answer
A:
Yes, the municipalities will still be sending authorization numbers.
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Do I need a log in and password for the Interim State Fiscal Agent (ISFA) system?
Answer
A:
Yes. That information will be sent to the email address that is on file in NYEIS.
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How do I get set up to begin electronic claiming with NYEIS?
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Visit http://www.cma.com/nyeis/NYEarlyInterventionInformation.html or contact the NYEIS help desk via nyeis@cma.com or 518-640-8390.
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Medicaid Enrollment
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Do we have to report our employees with Medicaid before we bill Medicaid?
Answer
A:
The eMedNY website has a FAQ page:
https://www.emedny.org/HIPAA/5010/FAQs/MI01_NPIReportingFAQS.pdf
that provides some good information. Essentially, an agency does need to report the NPIs of their employees. Providers may do this themselves through ePaces (see
https://www.emedny.org/HIPAA/NPI/Facility%20Practitioner%20NPI%20Reporting%20%28Web%20Instructions%29.pdf
). Additionally, the NYS fiscal agent has agreed to help facilitate this process by transmitting batch files for billing providers, as new rendering providers are encountered on claims.
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Do we need to wait for approval as a Medicaid provider before we submit those children's bills, as it could take 3-4 months to hear for approval?
Answer
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No, you can submit claims to both NYEIS and KIDS (through www.EIBilling.com). However, the claims will not be reimbursed without the Medicaid Provider #.
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How do we register our NPI numbers with this ETIN?
Answer
A:
If you would like to obtain an ETIN, visit
https://www.emedny.org/info/ProviderEnrollment/cmcm/Option2.aspx
for the forms
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Should agencies complete the Electronic Funds Transfer Authorization Forms from Medicaid?
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This is the billing provider's choice. The billing provider can either have Medicaid payments directly deposited into their account or have a check mailed to them.
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Should we be obtaining an ETIN number or is the NYS fiscal agent considered to be a service bureau/billing agent?
Answer
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The interim fiscal administrator (IFA) is considered a service bureau/billing agent. The IFA will use their own ETIN for submitting electronic claims (837 files) and retrieving electronic remittance advice (835 files).
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Should we sign up for the electronic remittances or is the state going to provide us the remittance?
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A:
The fiscal agent will get the electronic remittances directly from Medicaid. They will not go to the provider.
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What is an ETIN?
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An ETIN is an Electronic Transmitter Identification number. It is used in the process for submitting and receiving electronic files.
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Which Medicaid enrollment form do I fill out?
Answer
A:
You should have received an email with instructions. If you did not receive this, contact BEI via BEI@health.state.ny.us.
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