Dear
Colleague:
Effective today, Early Intervention (EI) billing providers no longer have to
enter Explanation of Benefits (EOB) remittance data into the EIBilling system
for United Healthcare, Cigna or MVP. PCG, the State Fiscal Agent (SFA),
working with the Department of Health (DOH), Department of Financial Services
(DFS) and these three insurers, has created, tested and implemented a system of
receiving, loading and reporting remittance data for claims made by EI billing
providers for children covered by United Healthcare, Cigna and MVP. 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 $16 million of remittance data sent
from United Healthcare, Cigna and MVP for claims paid April 1, 2013 through
February 28, 2014.
United
Healthcare, Cigna and MVP have now built the capabilities to generate and send
the remit file to the SFA on a routine basis and the SFA 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 system from original claiming to complete adjudication,
and payment from the escrow account for denied or partially paid claims.
EI billing
providers will be able to review the remittance data for claims for services to
children covered by these insurers on EIBilling.com. Although not
recommended, to avoid duplicate data, providers will have the ability to
continue to enter remittance information for these insurers from paper EOBs via
EIBilling.com for a limited time.
Should EI
billing providers have questions about United Healthcare, Cigna or MVP
remittance data on EIBilling, they should contact the PCG Customer Services
Center at 1-866-315-3747.
DOH, DFS, and 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, Oxford, Empire BCBS of NY/Health Plus,
Affinity, Fidelis, Independent Health and Hudson Health. DOH and SFA will
provide updates on the completion of those remittance processes as they occur.
SFA also
wishes to remind providers that they no longer have to enter EOB remittance
data themselves into EIBilling.com. SFA is providing manual entry of this data
to providers who wish to take advantage of this service. For more information
about how to take advantage of this service, please click here.
Please do
not reply to this e-mail announcement.
Thank You.