522- Important Steps for Billing Providers Using EI-Hub Service Logging

New York State Department of Health
 New York Early Intervention System (NYEIS) Electronic Mailing List
 
 Important Steps for Billing Providers Using EI-Hub Service Logging

Dear Colleague: 

This message is intended for billing providers who utilize the EI-Hub Service Logging module. We have received feedback from providers facing billing challenges and concerns about potential payment delays as rendering therapists are not populating on service authorizations and in other service logging dropdowns. To address this, please follow the steps below to ensure that your account, and the accounts of your staff, are correctly set up for billing. 

Key Setup Instructions: 

The Service Logging module is integrated with the Case Management (CM) module. The system uses service authorization details from Case Management, as well as therapist profile information, to validate claims. For security reasons, any rendering provider you wish to bill on behalf of must have both Health Commerce System (HCS) and EI-Hub CM user roles. This ensures the rendering provider is recognized in the system as an approved therapist. 

Please ensure the following setup for your rendering provider’s EI-Hub account and therapist profile: 

1. EI-Hub Account: User Role Configuration: (Must be completed by a Role Administrator) 
   
   

• Ensure the user's name and email address are entered in their EI-Hub account under User Management > User Details. 
  
  
• Confirm that staff members have the appropriate rendering provider CM user role (e.g., RenderProvNY, JrRenderProvNY, or ISC/OSC NY) under User Management > Role Matrix. If staff members are expected to log their own services, they must also have the Service Logging module configured to their account.

2. Therapist Profile: (Editable by users with the UniversalProvNY role; Role Administrator status not required) 

• If a rendering provider's name does not appear under the entity when configuring their user role, their therapist profile may be incomplete. Verify that the profession and employment type are correctly entered. For guidance, please reference the following job aid. 
  
  
• Check that the rendering provider is marked (checkbox) as ‘Active’ under Therapist > Demographics > Basic Demographics. This information is also visible in the search results under Therapist Lookup. If the provider is inactive (checkbox not marked), contact the PCG Call Center for assistance. The fastest way to get support is by submitting a Web-to-Case form. Include the phrase "Inactive Therapist Checkbox" in the subject line and ensure the provider's name and NPI number are included in your support request.  

Claiming process:  

After a claim is created, it will transition to the View Hold Visit queue. This queue allows independent providers or agency fiscal staff to review the claim before it is sent to Case Management (CM) for placement on a voucher. Providers must select the claim(s) they wish to proceed through the billing process by selecting all claims > selecting batching actions, toggle hold status > change hold status. Please reference this micro eLearning video for a quick tutorial.  

Following this: 

• Approved claims will appear in the Bill to State menu and can be added to a voucher. Once the voucher is created, click the Complete button to submit the claims for payment processing. (Attendance Bill to state)
  
  
• Rejected claims will be listed in the Unbilled Claims Report. (Attendance > Reports > Unbilled) 

Addressing Billing Rejections: 

We have also received reports of billing rejections, often related to "missing a referring provider" information. Please note:

• The ‘Scripts, Orders, Recommendations and Referrals’ panel must be completed for all claims with the referring provider NPI number (individual or institution) providing the service. This is required once per service authorization and does not necessitate a physical prescription. Users must use the NPI lookup feature when completing this panel. (Child > Ins Info > Scripts, Orders, Recommendations and Referrals) Please reference this micro eLearning video for more information.  
  
  
• For more details on handling rejections, refer to the 277 Rejections Guide. While designed for 837 billing providers, the guide contains valuable information that also applies to Service Logging users. 

Additional Resources: We hope this information clarifies the process and outlines all the essential elements for effective use of Service Logging. For further guidance on Service Logging, please review the resources linked below. 

• Service Logging job aid 
• Billing and Claiming job aid 
• Best Practices to reduce Billing Rejections micro eLearning video 
• Billing rejection Report micro eLearning video 
• Creating a voucher micro eLearning video 

Please do not reply to this e-mail announcement.

Thank You.

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