DOH Announces Change in Medicaid Electronic Remittances Release Dates

The Department of Health (DOH) has announced that it is changing the release date for electronic remittances.  Under new federal requirements, the remittances will no longer be available two weeks in advance of payments.  LeadingAge NY has confirmed with eMedNY that providers may still contact eMedNY up to two weeks in advance of their scheduled payment release in order to ascertain their total check amounts.  This should allow members sufficient notice to manage their cash flow.  Therefore, the only change is in timing of the release of the electronic remittance.  In general, for denied claims providers have 60 days from the date of the denial or the remittance to re-submit claims.

The following notice, posted on the eMedNY website (http://www.emedny.org/), provides additional detail concerning this change:

Medicaid Required by Federal Law to Change Electronic Remittance Delivery Date

 

Effective April 7, 2014 (Cycle 1911) eMedNY will no longer be permitted to make the X12 835 and the X12 820 electronic remittances available two weeks prior to release of payment. Electronic remittances will be available two days prior to the release of funds. The change is necessitated by requirements of Section 1104 of the Affordable Care Act (ACA) and the CAQH Committee on Operating Rules for Information Exchange (CORE), the authoring entity for operating rules for Electronic Fund Transfer (EFT) and Electronic Remittance Advice (ERA) transactions. CORE Rule 370 requires that transmission of the 835 cannot occur more than three days prior to the availability of the EFT. 

 

All providers receiving the 835/820 electronic remittance are affected and it is important that they assess what impact, if any, the change in the 835/820 delivery date may have on their business. The change will be implemented on April 7, 2014. Therefore, electronic remittances for cycle 1911 that would have been available on 04/07/14 will not be delivered to eXchange or FTP accounts until 04/21/14, 2 days before the Check/EFT release date. No electronic remittances will be delivered on 04/07/14 and 04/14/2014. For these two cycles electronic remittances will be released as follows:

 

Cycle       Payment Issue             Electronic Remittance Issue            Payment Release

1911         04/07/14                                04/21/14                                   04/23/14

1912         04/14/14                                04/28/14                                   04/30/14

 

The current payment schedule will not be impacted by this change. Payments will continue to be lagged for two weeks and two days from the issue date.

 

Information on the CORE Operating Rules can be found at: http://www.caqh.org/ORMandate_index.php.

 

Questions? Contact the eMedNY Call Center at 800-343-9000 or email nyhipaasupport@csc.com

 

Source: NYS Dept. of Health (http://www.emedny.org/)

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827