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Dashboard Information Test Environment. Practitioners can submit certain maintenance transactions in the Provider Enrollment Maintenance Portal instead of mailing a paper form. Click for more information. Any changes reflected in the manuals are effective for dates of service beginning April 1, Pharmacy coverage questions can be directed to NYRx health. Billing related questions can be directed to GDIT at

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The information contained in this document will assist providers enrolled in the New York State NYS Medicaid Program with understanding and complying with Medicaid requirements for billing and submitting claims electronic or paper. Providers should use the information in this document along with the Medicaid Provider Manual posted at www. The Technical Supplementary CG is available at www. The following is an explanation of the information contained in the matrix and instructions for use. For original claims the entry should be 0 zero. Format will vary depending on rate code monthly, 1 st half month, 2 nd half month, daily. Enter A3 or B3 followed by the amount the other insurance carrier paid. UB04 Instructions: The charged amount for the entire claim must be entered on the line corresponding to Revenue Code Medicaid and one Primary Payer: Enter the name of the primary payer in line A of this field. Leave Line C blank. Medicaid and two Primary Payers: Enter the name of the primary insurance carrier on line A. Enter the secondary payer in line B. However, providers are strongly encouraged to begin reporting their billing provider's NPI information, as soon as possible. Note: When other payers are involved, and Medicaid is being indicated on lines B or C, enter the patient ID for the other payer or the word "None" on the lines above the Medicaid ID number. Note: The adjusted claim may not contain more claim lines than the original claim.

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Upon notification of an upcoming license expiration, practitioners can sign in to the eMedNY portal to view their license information. If needed, the license end date can be updated, and a copy of the professional license renewal can be uploaded. Practitioners who have been notified that their license will expire or have been terminated from the Medicaid FFS program due to an expired license can update their license or reactivate their enrollment via the eMedNY portal. Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider.

Want to view the training webinar on your own time? Please view the recording of it here. Businesses, groups, and institutions will be able to use the Provider Enrollment Maintenance Portal at a later date. Practitioners are encouraged to use the Provider Enrollment Maintenance Portal to submit enrollment maintenance transactions and view the status of submissions. Available transactions include: submitting address changes, performing Drug Enforcement Administration DEA updates, affiliating individuals to groups, adding specialties, and updating Electronic Funds Transfer EFT information. First, read or print the instructions in Step 1 through Step 6. Click here to print all steps. Having an issue? Feel free to give us a call at All Rights Reserved.

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Do you need to make a change to your current enrollment record? Do you want to correct an existing NPI for your current Enrollment? Did you receive a letter advising you to Revalidate your enrollment? Have you experienced an Ownership Change? If any of these questions apply to you, click on your provider type on the right. As of March 25, , new Federal Rules and Regulations surrounding provider screening and enrollment have been in effect. Changes include: additional screening may be required, all ordering and referring physicians or other professionals providing services under the State plan or under a waiver of the plan must be enrolled as participating providers, revalidation of enrollment of all providers at least every five 5 years, and an application fee may apply.

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If you need help finding what you're looking for, please visit our Site Map, use the search above, or you can contact us directly for assistance. For automatic play, exit your mouse cursor from the box. Provider Name This refers to the name of the Billing Provider. Please leave out the '-' when entering the number in the field. If you have any concerns about your health, please contact your health care provider's office. Your browser does not support iFrames. The information contained in this document will assist providers enrolled in the New York State NYS Medicaid Program with understanding and complying with Medicaid requirements for billing and submitting claims electronic or paper. Start-Up Half Month. This refers to the address of the Billing Provider. Back to Top. Access the EmblemHealth Portal. Dental Corner. This field is used to indicate the specific condition or status of the patient as of the last Date of Service indicated in Field 6. Leave Line C blank.

Dashboard Information Test Environment. Practitioners can submit certain maintenance transactions in the Provider Enrollment Maintenance Portal instead of mailing a paper form.

If you have any concerns about your health, please contact your health care provider's office. Billing related questions can be directed to GDIT at Hover your mouse over the notice box to stop playback. Provider Manual. The tax number entered on the form must match the tax number for the provider NPI on the form. Navigation Open. Sign In. This refers to an 8 digit identification number for the Billing Provider. UB04 Instructions: For record-keeping purposes, the provider may choose to identify a patient by using an office account number. Select the appropriate code from the UB04 Manual. This website is provided as a service for providers and the general public, as part of the offerings of the electronic Medicaid system of New York State. If the ordering. Access the EmblemHealth Portal. Note: The adjusted claim may not contain more claim lines than the original claim.