#MY DIGITAL OFFICE ROCHESTER NY UPGRADE#
This upgrade will not affect the current functionality of these applications.
To align with the most current security standards, eMedNY will be upgrading our infrastructure components on Novemthat will affect a number of applications used by the Provider Community. Medicaid is the payor of last resort and all third-party coverage must be exhausted or documented to be a non-covered service before nursing services are reimbursed by Medicaid.Īttention: Scheduled Maintenance for Server Upgrade November 7, 2021 It is the billing provider’s responsibility to determine if the member has third party (private insurance) in addition to Medicaid.
If documentation is not received, payment for claims pended for Edit 02304 (zero fill) might be delayed. If you have previously sent in a letter or Explanation of Benefits (EOB) for calendar year 2021, new documentation will be needed for dates of service after January 1, 2022. Prior approval for all PDN services is required before the start of providing services.Īttention: Reminder: Private Duty Nursing (PDN) Billing for members with Third Party Health Insurance– Guidance for Claims SubmissionĪs the new calendar year approaches, we want to remind you that zero filled claims require updated documentation from the primary payer to process your claims.
#MY DIGITAL OFFICE ROCHESTER NY MANUAL#
PDN Providers will continue to follow the current submission process outlined in the PDN Manual PDN Manual on the eMedNY websiteĪll new cases and renewals must be submitted by a Medicaid enrolled PDN provider (independent nurse or nursing agency) though ePACES or through the mail using a paper prior approval request form. The portal will also ensure the accurate completion of forms and will provide step-by-step instructions to guide practitioners through the process.Īttention: Westchester County Fee-for-Service Private Duty Nursing Prior ApprovalsĮffective January 10, 2022, all Fee for Service (FFS) Medicaid Private Duty Nursing (PDN) requests, including those from Westchester County, will be reviewed and adjudicated by the Office of Health Insurance Program’s Bureau of Medical Review PDN Prior Approval Unit. The portal will enable practitioners to perform numerous maintenance transactions using an easy online process and act as an alternative to the current enrollment process (by paper), reducing turnaround time by eliminating the need for United States Postal Service (USPS) delivery. Edit/Error Knowledge Base (EEKB) Search ToolĪttention: New Provider Enrollment Portal Coming Soon to eMedNY Beginning in Spring 2022, New York State (NYS) Medicaid practitioners will have access to a new Provider Enrollment Portal, developed by the NYS Department of Health (DOH) and eMedNY.National Diabetes Prevention Program (NDPP).Medicaid Managed Care Network Providers.Enrolled Practitioners SEARCH (including OPRA).
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