155- 2014 Article VII Payment to Providers

The enacted SFY 2014-15 New York State Budget includes legislation that allows for payment of specific claims to providers of Early Intervention (EI) services.  Applicable claims are those submitted to third-party payers, including Medicaid, from 4/1/13 to 6/30/13, for which no payment or determination has been made. Payment of above said claims will be made from EI Escrow Accounts and will be processed by the State Fiscal Agent (SFA) for the New York State Department of Health.  These payments are subject to recoupment of overpayments and a portion of any remaining safety net balance.    

The legislation requires that payment be made to affected providers on the 45th day following the date the budget was enacted.  Therefore, the SFA will issue payment to providers for these claims on May 16, 2014.  This special payment can be identified in EI Billing under the Escrow Check report.  The payment will have a check number beginning with a zero (0) followed by five (5) digits.  For example, 000001, 000012, 000123.

EI providers will continue to be responsible for working with the SFA to provide information or documentation needed to complete the claims adjudication process with third-party payers.

If you have any questions please call PCG Customer Service Center at 866-315-3747.