PCG has found that there has been increase of rejections from Medicaid for A7:521-Invalid Claim Adjustment Reason Code (CARC). It has been determined that this is occurring due to incorrectly entered commercial EOBs that are either missing a group code or have an incorrect CARC posted. Medicaid will not be able to correctly process claims if there is not a complete and valid denial posted. Please follow the link for additional details and guidance.

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 Bureau of Early Intervention (BEI) is implementing an ATB 1% rate increase on payments for Early Intervention (EI) services, including Service Coordination, Evaluations and General Services. The 1% rate increase will be reflected in both Medicaid and Escrow payments. The rate increase will be retroactive and apply to services rendered on or after 4/1/2022. For more information, please follow the link.

On September 1, 2022, the Bureau of Early Intervention sent an email communication to EI Program stakeholders providing an update on the EI-Hub Sandbox user experience. The Bureau and PCG acknowledge the challenges experienced during the roll out of the Sandbox, but believe the Sandbox will provide system users with hands on experience that will help to prepare for the launch of the EI-Hub. BEI will provide approximately two months notice before the EI-Hub launch date. To read the full communication, please follow the link.

As of September 23, 2022, United Healthcare will no longer print and mail overpayment/recoupment notification letters. Information will be sent electronically via the UHC Provider website. For more information, including instructions for how to access notification letters electronically, please follow the link.

This message is to inform you that your Medicaid claims, which were submitted by Public Consulting Group (PCG) on June 1, 2022, were not processed by Medicaid as expected. Although PCG submitted the claims prior to the submission deadline, Medicaid was unable to process claims in a timely manner given the volume of claims received this week. As a result, you will not receive your payment from Medicaid as expected in cycle 2337. Claims that were processed late by Medicaid will become part of cycle 2338 and all payable claims will be paid on June 29th. If you are a provider who remained on the accelerated schedule you should receive payment on June 13th. This cycle will also include all claims submitted and processed by Medicaid through June 8th, 2022. We will keep you apprised of any changes or updates we may receive from Medicaid regarding future payments. If you have any additional questions, please contact us at 1 866 315 3747.

Effective July 1, 2022, New York State certified school psychologists will no longer be recognized as qualified personnel in the Early Intervention Program. The attached document explains the background for this change, implementation activities that must occur prior to July 1, 2022, and upcoming activities related to the addition of four new professions that will be recognized as qualified personnel in the Early Intervention Program. Please follow the link to view the document.