Any agency who are entering Extraordinary Circumstances (ECs) are invited to review the training video posted on the Training page, under ‘Webinars’. These ECs are not entered on a per claim, per child, or per authorization basis, but rather just entered once for the entire overlapping date range the agency is affected, and should be entered within 30 days of relief date. Please follow the link for additional information.

A recent update of EIBilling included an enhancement of the Provider Payment Profile Report, specifically the inclusion of a new row titled 'Closed' claims., Follow this link for additional information on this report update.

When utilizing the Medicaid 835 Remittance Detail Report, please note that there are 2 new date fields, From and To Date (for dates of service). Please select From Date of 4/1/2013 and To Date of current date in order to view all claims within the chosen cycle. Please follow the link to see an image of the date fields.

Have you experienced one or more of the following: Pages repeatedly loading or lagging? Login/sign-in problems? Images or videos not loading? If the answer is 'Yes' to any of these questions, clearing the browser cache may improve performance. Follow this link for guidance on clearing the browser cache on Android phones and iPads/iPhones.

The SFA has noticed an increase in Aetna rejections due to provider or therapist NPI number not being registered with Aetna. Please follow the link to register your NPI number with Aetna. You may choose to send in five or fewer at a time or request a spreadsheet to submit more than 6 at a time. This will ensure that your claims will be accepted and adjudicated by Aetna.

In accordance with Federal Law, Providers who received payments for Early Intervention Services in the 2021 calendar year should expect to receive a number of 1099 forms. Providers will receive a 1099 from New York State Department of Health via the State Fiscal Agent (SFA) for amounts from the State Escrow account in 2021, a 1099 from Medicaid, and a 1099 from each insurance company. Please follow the link for details.

The State Fiscal Agent, PCG, has identified an issue with some payers rejecting claims when the child’s or provider’s address does not contain a 9-digit zip code. Payers use the US Postal Service to verify all addresses, and often require the 9-digit zip code for verification. Please follow the link for more information on looking up a 9-digit zip code.

New York State Medicaid recently notified the State Fiscal Agent, PCG, of excessive denials for ICD-10 code R63.3 and issues with the use of ICD-10 code Z13.40. Please follow the link for more information.

PCG has received several calls regarding TriZetto ERA enrollment for Healthfirst. Please note that Healthfirst requires EFT enrollment prior to ERA enrollment. PCG has sent EI Billing Providers the ERA enrollment form from Change Healthcare which designates TriZetto GATEWAY1 as the ERA receiver. This form should be sent to NYSFAEIP@pcgus.com after EFT enrollment has been completed. Follow the link for instructions on how to complete EFT enrollment for Healthfirst:

On December 29, 2021, Governor Hochul signed legislation (A.5339/S.5560A) that significantly changes the way claims for Early Intervention services will be processed and paid. Please follow the link for more information.