New York State Department of Health
New York Early Intervention System (NYEIS) Electronic Mailing List
Code 35 Claims Payment to Providers
Dear
Colleague:
In follow-up to the previous communication to the field on unresolved service
coordination claims due to Code 35 restriction:
On October
21, 2014, the Early Intervention State Fiscal Agent (SFA), processed a special
check run totaling $1,423,971.82 for service coordination services claims
submitted to Medicaid that remained unresolved for over 90 days as of October
1, 2014, due to the child being a restricted recipient and the current provider
not on Medicaid’s file for the child.
Claims
selected for reimbursement meet the following two criteria:
·
Early
Intervention (EI) service coordination claims received by EIBilling prior to
July 1, 2014.
o
For
NYEIS: Claims received by the SFA for processing prior to and including Monday,
June 30, 2014
o
For
KIDS: Claims approved and processed by the municipality prior to July 1, 2014
- Service
coordination services claims remain unpaid and in a Code 35 Medicaid
denial status
As a
reminder, the SFA will continue to pursue Medicaid reimbursement for service
coordination services claims and adjustments will be made to provider payments
as Medicaid payments are received for these claims.
If you have
any questions, please call the PCG Customer Service Center at (866) 315-3747.