MIF Claim Submission Guidance - Provider Claims - NY 2025

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The Future of the Medical Indemnity Fund The state Health Department quietly announced the closure on its website. Budget officials in the state allocated $58 million in state funds to continue the program through 2025. Currently enrolled children will still get their promised benefits.
Claims must be submitted within two years of the date of service. All claims submitted beyond the 90-day timely filing window must include Delay Reason Code 03.
A provider has a right to file a dispute in writing to PHC California within 365 day from the date of service or the most recent action date, if there are multiple actions.
Overall Submission requirements If you are a member submitting a claim, please refer to the MIF Claim Submission Guidelines for Members available on the MIF website. All completed claims are required to be received by the MIF within 90 days from the date services are rendered or purchased.
A: The Medical Indemnity Fund (Fund or MIF) was established in 2011 to provide a funding source for future health care costs associated with birth-related neurological injuries.
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Its the specific timeframe you have to submit a claim to an insurance company for reimbursement. Each insurer sets its own deadline, typically ranging from 30 to 180 days from the date of service.
If you have any questions about obtaining authorizations or submitting claims, please contact us: NYDOHMIF@pcgus.com or call 1-855-NYMIF33 (1-855-696-4333).

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