Emedny 150003 2025

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The document outlines the general billing guidelines for New York State Medicaid, specifically focusing on the eMedNY system used by providers to submit claims for Medicaid-covered services. It details the processes for electronic and paper claims submission, including necessary forms, instructions for completing claims, and requirements for specific situations such as Medicare crossover claims. Additionally, it includes appendices with code sets and consent forms related to sterilization procedures and hysterectomies.

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Does NY Medicaid accept corrected claims?

In these cases, providers must resubmit a new claim that addresses the reasons for the original rejection. It is critical that providers use the Request for Claim Review Form to submit a corrected claim. Corrected claims submitted on a standard claims form cannot be recognized and will be denied as a duplicate claim.

How do I submit a claim to Epaces?

Submitting a Batch Once a batch is built, it needs to be submitted. Select Submit Claim Batches from the left-hand menu bar. A page with all claim batches ready for submission to eMedNY for processing is displayed. Some or all of the batches displayed may be selected for submission.

What is the timely filing limit for Medicaid claims in NY?

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.