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How to use or fill out eMedNY Remittance Retrieval with our platform
- Click ‘Get Form’ to open the eMedNY Remittance Retrieval in the editor.
- Begin by entering the date at the top of the form. This is essential for record-keeping.
- Fill in your Provider/Group Name and complete the address section, including City, State, and Zip Code.
- Input your Provider Number and NPI in the designated fields to ensure proper identification.
- Authorize eMedNY to release your remittance records by listing individuals within your organization. Provide their names, addresses, and phone numbers as required.
- If you need to authorize more than two individuals, attach an additional sheet with their details.
- Sign and date the form at the bottom. Ensure that it is signed by an authorized individual from your organization.
- For future requests, remember that one of the listed individuals must initiate any request using the Remittance Copy Request Form on page 2.
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