Public Consulting Group - Recent News

EI-Hub Waivers Update on Billing Edits

Sat, 02 Nov 2024 14:38:00 GMT

EI-Hub Waivers Update on Billing Edits

Dear Colleagues,

The Bureau of Early Intervention (BEI) has received multiple communications from municipalities and providers regarding the waiver process in EI-Hub and the related claims rejections. BEI has met with Public Consulting Group (PCG) and determined that the Waiver Billing edits in the EI-Hub be temporarily relaxed during the initial transition period of the of EI-Hub. This change will decrease work volume for municipalities and providers.

While waiver entries on the IFSP in the Case Management Component of EI-Hub are visible, these are for informational purposes to indicate which services have a waiver based on the agreed upon services for the child and family. While this temporary change has been made, please be aware:

This is effective for claims submitted 11/1/2024.
Providers will not receive claims rejections related to the below waiver errors.
Providers will not need to enter a waiver in the Waiver Request panel.
Providers may rebill claims for all dates of service which have been submitted in EI-Hub and rejected for the errors below.
Municipalities are not required to review the Waiver Submission dashboard to approve waivers.
Existing waivers will remain in EI-Hub.
IFSPs will continue to generate waivers where applicable, and the decision will be shown in the Waiver panel when the EIO/D reviews the service on the submitted IFSP however no further action on the waiver is needed in the EI-Hub at this time.
BEI and municipalities continue to have the ability to review billing practices for appropriate billing of services. Reports in the case management and billing portals in the EI-Hub can be utilized to review claims.

Status Codes	Entity Codes	Category Codes	Short Description	EM-Error Message
612	F36	A3	No Waiver approved	Exceeds Basic Home & Community Based Visit limit; 3/Day; No Waiver approved
612	F37	A3	No Waiver approved	Exceeds Extended Home & Community Based Visit limit; 3/Day; No Waiver approved
612	F38	A3	No Waiver approved	Exceeds Basic Home & Community Based Visit limit; 1/Day/Discipline; No Waiver approved
612	F39	A3	No Waiver approval	Exceeds Extended Home & Community Based Visit limit; 1/Day/Discipline; No Waiver approved
612	F40	A3	No Waiver approved	Exceeds Basic & Extended Home & Community Based Visits limit; 3/Day; No Waiver approved
612	F41	A3	No Waiver approved	Exceeds Basic & Extended Home & Community Based Visits limit; 1/Day/Discipline; No Waiver approved.
612	F42	A3	No Waiver approved	No more than 1 Office/Facility Visit per Discipline per Day
612	F43	A3	No Waiver approved	Exceeds Office/Facility Visit Limit; 3/Day; No Waiver approved.
612	F44	A3	No Waiver approved	Exceeds Parent/Child Group Visit Limit; Max 1/Day; No Waiver approved
612	F45	A3	No Waiver approved	Exceeds Family/Caregiver Visit Limit; Max 2/Day; No Waiver approved
612	F46	A3	No Waiver approved	Exceeds Group Developmental Visit limit; Max 1/Day; No Waiver approved

BEI and PCG remain committed to ensuring the success of the EI-Hub. If you have any questions about this message or the waiver process, please reach out to the PCG Call Center at 866-315-3747 or by using the Web-to-Case feature, accessible under the 'Help' section (blue menu bar) in the EI-Hub or on the Learning Management System (LMS) under ‘Quick Links’

NYS Department of Health (Department) is offering a Stopgap Payment to Early Intervention providers while issues with implementation of the EI-HUB are remediated.

Sat, 02 Nov 2024 14:38:00 GMT

Provider Payments for Approved EI Billing Providers currently in Appendix Agreement

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

November 1, 2024

Dear Early Intervention Provider:

On October 15, the Early Intervention Program transitioned from the New York State Early Intervention System (NYEIS) to a new data system, the EI-HUB. Given system challenges, providers are experiencing challenges submitting claims. In recognition of this disruption, the NYS Department of Health (Department) is offering a Stopgap Payment to Early Intervention providers while issues with implementation of the EI-HUB are remediated.

The Stopgap payment will be calculated based on a provider’s average biweekly escrow payment submission. The Stopgap payment will be reconciled commencing once the provider has successfully submitted claims in the EI-HUB by assigning to the Department twenty-five percent of each early intervention payment payable from the escrow account until such time as the State Stopgap payment is fully recovered. Providers must also agree to repay any remaining balance within 30 days of notice to the provider that funds are outstanding.

Providers who wish to participate in the State Stopgap payment must execute an amendment to the Provider Agreement held with the Department. To participate in State Stopgap payment program, providers must request the Provider Agreement Amendment by sending an e-mail to provider@health.ny.gov and EIP.Fiscal@health.ny.gov. Please include in the e-mail the provider’s name, address, e-mail address, phone number, and STOPGAP in the subject line.

For providers requesting the Provider Agreement Amendment, the Amendment will be emailed to the provider’s email address indicated in their request email. The Provider Agreement Amendment must be signed, notarized, and returned via US Mail before the State Stopgap payment can be issued. Provider Agreement Amendments should be returned to the following address:

Bureau of Early Intervention

ESP Corning Tower, Room 287

Albany, NY 12237-0660

Attention: Provider Approval Unit

We are requesting that you return the Provider Agreement Amendment as soon as possible after receipt to ensure a timely Stopgap payment. Please contact the Bureau of Early Intervention at 518-473-7016 if you have any questions. Thank you for your prompt attention to this matter.

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NYS Department of Health

Bureau of Early Intervention

Phone: (518) 473-7016 (press 1)

Fax: (518) 486-1090

www.nyhealth.gov/community/infants_children/early_intervention/

Need Help using the Learning Management System (LMS)

Sat, 01 Jun 2024 14:37:00 GMT

EI-Hub Help: Using the Learning Management System (LMS)

The hyperlink above provides information on accessing the Learning Management System (LMS) for the first time and viewing training resources to support users in completing the essential functions in a child's life cycle in the Early Intervention Program (the Backward 'S').