May 09, 2013
New York State Department of Health
Bureau of Early Intervention Electronic Mailing List
Updates on EIP Billing and Claiming
Dear Colleague:
The purpose of this communication is to inform you of the progress made by the NYS Department of Health (Department) in implementing fiscal management of the Early Intervention Program (EIP). As stated in previous communications, the Department has contracted with James McGuiness & Associates, Inc. to act as the interim Fiscal Agent for the processing of early intervention claims and payment. The Department has also awarded a contract to Public Consulting Group to serve as the final State Fiscal Agent.
The Department has established provider agreements with 1,188 EIP providers. The Office of Health Insurance Programs (OHIP) has enrolled 224 EIP providers in the Medicaid Program and has supplied these providers with Medicaid ID numbers for billing purposes. OHIP has also updated the eMedNY system to allow processing of provider bills using EIP rate codes.
State escrow accounts to receive deposits from municipalities and to disburse payments to providers have been established. The Department has invoiced municipalities for the first deposit owed to the escrow account to cover provider payments. Checks have been received from 48 municipalities, and a total of $23,699,018.00 has been processed by the Department to support payments to providers from Key Bank.
NYEIS version 2.1 has been successfully implemented and provider bills submitted using the New York Early Intervention System (NYEIS) beginning April 1, 2013, are now being routed to the Department for transmittal to James McGuiness & Associates. The first claiming cycle for claims approved between April 1 and April 15, 2013 includes 157,879 provider claims, totaling $11,924,657.94. Of these:
- 45,474 bills totaling $3,437,969.25 are for services not covered by either Medicaid or commercial insurance. These claims are being submitted directly to Key Bank for processing and payment from municipal funds deposited in the Early Intervention Program escrow account.
- 78,226 bills totaling $5,829,318.75 are being submitted to eMedNY for adjudication by the Medicaid Program. Accurate claims submitted to the Medicaid Program will be paid in full.
- 31,017 bills totaling $2,311,544.50 are being transmitted to commercial insurers for adjudication.
- 3,162 bills totaling $231,087.25 covered by commercial insurance and the Medicaid program are being submitted to both payers.
The new website, https://www.EIBilling.com, developed for billing of EIP services by providers and managing claims to third party payers on an interim basis is fully operational. As of April 25th, there were 1168 providers with active log-in IDs and passwords using EIBilling.com and 313 municipal users from 54 different counties. Also as of April 25th, there were 202,224 KIDS service records, totaling $1,407,853.25 in claims, submitted by providers from thirty-seven counties through EIBilling.com for processing.
Details on how to navigate this new website are now depicted in a training webinar, which can be accessed at the following link: https://www.eibilling.com/Public/Webinars/Webinars.aspx
The Department will send another informational update early next week with the status of payments in each of the respective categories.
Please do not reply to this e-mail announcement.
Thank You.