Dear
Colleague:
Effective today, early intervention (EI) providers no longer have to enter EOB
remittance data into the EIBilling system for Excellus. PCG, the State Fiscal
Agent (SFA) working with DOH, DFS and Excellus, has created, tested and
implemented a system of receiving, loading and reporting remittance data for
claims made by EI providers for children covered by Excellus. This will improve
the ability of providers to receive timely payments and reduce manual data
entry by providers.
The SFA has
received, loaded and reviewed more than $1.1 million of remittance data sent
from Excellus for claims paid between April 1, 2013 through December 7, 2013.
SFA is currently loading new files just received from Excellus through January
27, 2014.
Excellus has
now built the capabilities to generate and send the remit file to the SFA on a
weekly basis and PCG is ready to accept and post these files when received. The
increased frequency of sending and receiving these files will improve the
overall payment cycle and move claims faster through the SFA from original
claiming to complete adjudication, and payment from the escrow account for
denied or partially paid claims.
Providers
will be able to review the remittance data for claims for services to children
covered by Excellus on EIBilling.com. Although not recommended to avoid
duplicate data, providers will have the ability to continue to enter Excellus
remittance information from paper EOBs via EIBilling.com for a limited time.
As a result
of loading these files, the SFA has found a number of payment issues and will
work with affected providers and Excellus to resolve some of the discrepancies
it found.
Should
providers have questions about Excellus remittance data on EIBilling, they
should contact the Customer Services Center at 1-866-315-3747.
DOH, DFS,
and the SFA continue to work with other insurers to obtain, review and load
remittance data. PCG is currently receiving and reviewing remittance files from
other major insurers including, Emblem, Empire BCBS of NY/Health Plus, MVP and
Cigna. DOH and the SFA will provide updates on the completion of those
remittance processes as they occur.
Please do
not reply to this e-mail announcement.
Thank You.