Medicaid Data Conflicts

Overview

The Medicaid Data Conflicts lists conflicts between data entered into NYEIS or KIDS and data entered into eMedNY.  The Medicaid Data Conflicts report is split into three tabs: CIN Conflicts, Name Conflicts, and No Medicaid Information Available.

The process for obtaining information is as follows:

• EIBilling.com receives data from NYEIS and KIDS that includes the CIN for a child
• EIBilling.com runs an eligibility check at eMedNY to determine what data is on file for that CIN.  This data should include first and last name, date of birth (DOB), and gender
• EIBilling.com reports any conflicts where the data in eMedNY does not match the data provided from NYEIS and KIDS
• EIBilling.com reports Medicaid eligibility

To get to the Medicaid Data Conflicts report, click under "Reports" in the menu, then drop down to click "Medicaid Data Conflicts."

CIN Conflicts Tab

The first tab on the Medicaid Data Conflicts report is CIN Conflicts.  This lists any conflicts between the data provided from NYEIS or KIDS and the data received from eMedNY, in terms of first and last name, DOB, or gender.  You can export all tabs to Excel by clicking "Excel (All tabs)" at the bottom of the page.

Name Conflicts Tab

The second tab on the Medicaid Data Conflicts report is Name Conflicts.  This list allows the provider to look at a difference in the name entered into NYEIS or KIDS and the name entered into eMedNY.  If a provider can determine that the information listed in NYEIS/KIDS and eMedNY is indeed information for the same child, the provider can confirm this to allow the IFSA to continue billing on their behalf.  To confirm a Name Conflict, check the box next to the child's name and click "Confirm Conflict" at the bottom of the page.  That child should no longer appear in that list.



No Medicaid Eligibility Information from eMedNY Available Tab

The third tab on the Medicaid Data Conflicts report is No Medicaid Eligibility Information from eMedNY Available.  This lists any children that EIBilling.com has not received data for from eMedNY. 

Children may be listed here, because EIBilling.com has not received a response to its inquiry to eMedNY.  If you see a response listed from eMedNY, but the child is still listed under this tab, there may be no information for that child entered into eMedNY.

Please note that if we are missing data from eMedNY, it does not mean there is an error or problem. It merely means we cannot confirm the information is correct, because we are missing information from eMedNY at this time.




Again, all tabs can be exported to Excel by clicking "Excel (All tabs)" at the bottom of the page.


Medicaid Data Conflict Resolution

For Providers:

For CIN conflicts that only list spelling or punctuation of a name differently, providers can resolve these conflicts by confirming them in the Name Conflicts tab.

For any other data conflicts, you will need to contact the municipality for further instruction on how to resolve the conflict.  You can check which municipality you need to contact for assistance by clicking "Details" next to a child's name under the CIN Conflicts tab.

For Municipalities:

If the data is clearly for two different children, then the problem is that the CIN entered into NYEIS or KIDS is incorrect.  You will need to take appropriate action to correct that data.  If you need further assistance, you will need to contact either the NYEIS help desk or the KIDS help desk.

If any other information is incorrect in NYEIS or KIDS, you will need to correct that information in the appropriate system.

If the information is incorrect in eMedNY, you will need to work with your local DSS to have them correct their records.