457- THIRD UPDATE: Transition to TriZetto Claims Clearinghouse

Please note: This is an update related to earlier communications from November 2, November 18, and December 3.

On December 16, PCG completed sending payer required forms and online provider enrollment instructions to all Early Intervention Program (EIP) Billing Providers. Forms and instructions were sent to the contact email listed in EI Billing. EIP Billing Providers should check this email for forms that require provider action. 

Please complete and return forms to NYSFAEIP@pcgus.com no later than Wednesday, December 22, 2021 to complete the transition to PCG’s new claims clearinghouse, TriZetto. If you have any questions about the enrollment forms or the transition to TriZetto, please contact us at NYSFAEIP@pcgus.com. 

Below is a complete list of regulated payers and third-party administrators for which PCG has enrolled EIP Billing Providers for claims submission and ERAs (835s). Please note that EIP Billing Providers have received ERA forms for payers for which they are currently enrolled for ERAs. 

PCG will also continue work to enroll EIP Billing Providers with their remaining payers (that they have not enrolled for ERAs with).

As noted in a previous update communication on December 3, certain payers do not allow auto-signing of enrollment forms and require additional EIP Billing Provider action. The following payers require signature by the EIP Billing Provider or online enrollment by the EIP Billing Provider:

If you have any questions, please email NYSFAEIP@pcgus.com or contact the PCG Customer Service Call Center at (866) 315-3747.