Billing Manual 6.26.2018.PDF
The information contained in the billing manual, subject to required State and Federal approvals, reflects the billing structures for the Children’s System Transformation scheduled to begin on January 1, 2019. TBD Billing criteria will be updated by the State. Future updates will only supplement current information, not change what is already in place.
Please use this manual to begin preparation of your claiming systems.
A supplemental billing manual, New York State Children’s Health and Behavioral Health (BH) Services – Children’s Medicaid System Transformation Guidance for the Transitional Period, will be released shortly that will include guidance on transitional billing procedures, including transitional billing procedures for waiver providers that will transition to Health Home rates and for HCBS services that will transition to State Plan services after January 1, 2019.
You can access your performance feedback and final score by:
Monroe County has consolidated opioid-related web content -- Health, Law Enforcement (in progress), training, general overview -- in one website:
Common Ground Health, working in partnership with the public health directors in each of our nine Finger Lakes counties,* is conducting an important health survey. I am writing to ask for your help.
We are gathering health stories from as many residents of our region as possible in order to learn more about our region’s health-related needs and help our county health departments develop strategies for addressing public health priorities. Please tell us your story through the survey below and then share the link with family, friends and colleagues. The survey will take 15 to 20 minutes of your time.
You can complete the survey anonymously, or enter your name and email for a chance to win a $500 gift card to a local supermarket or gas station. **
To begin the survey in English, click here: MyHealthStory2018.com. For Spanish, follow this link: MiHistoriadeSalud2018.com.
I can’t thank you enough,
Trilby de Jung
*Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates counties
**Survey participation is not required to enter the drawing. See official rules here.
Complimentary Webinar from Garfunkel Wild, PC Attorneys at Law
"Right to Try" Act: What you need to know
Wednesday, June 20, 2018
12:00 PM - 1:00 PM EST
On May 30, 2018, a new Federal "right to try" act became effective which gives patients with life-threatening conditions the right to use experimental medications without the approval of the Food and Drug Administration. This new Federal law impacts Hospitals, Physicians, Drug Manufacturers and Patients. Join us as we explore the consequences and questions of this new law.
Andrew E. Blustein
Lara Jean Ancona
Stacey P. Klein
Registration is limited. After registering, you will receive a confirmation email containing information about joining the webinar.
CMS has discovered an issue with the 2018 Quality performance category specialty measure sets within the updated “Explore Measures” tool on the Quality Payment Program website. They have temporarily removed the 2018 Quality performance category measures from this tool to improve the accuracy of the specialty measure sets. They will send a notification when the issue is resolved.
In the meantime, please visit the 2018 QPP Resource Library on CMS.gov to view additional details on the 2018 Quality measures. You can download the Claims and Registry Measures, Web Interface Measures, and Quality Measure Specifications Supporting Documents to learn more.
If you have any questions, please contact the Quality Payment Program Service Center by:
Beginning Monday, 7/10/2018, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim.
No more delays.
Parent information fact sheet from NYS Health Foundation.
Click here to download.
On 4/2/2018, CMS started mailing new Medicare cards with the Medicare Beneficiary Identifier (MBI) to all people with Medicare and will continue to mail
On 4/2/2018, the Centers for Medicare & Medicaid Services (CMS) started mailing new Medicare cards with the Medicare Beneficiary Identifier (MBI) to all people with Medicare and will continue to mail new Medicare cards in phases by geographic location. This means that some of your patients may have already received their new Medicare card containing the MBI.
If you are currently registered with NGSConnex, our free, secure internet portal you will be able to login and use the MBI Lookup Tool to obtain your patient's MBI, if CMS has mailed them their new Medicare card. To use this new self-service tool in NGSConnex, you will be required to validate using reCaptcha software and also you will need to enter the following search criteria:
We encourage you to watch this three-minute video, to learn more about the MBI Lookup Tool available in NGSConnex.
If you are not already a registered NGSConnex user, we strongly encourage you to register now and take advantage of all the time money and time saving features NGSConnex has to offer.
This is a reminder that health care providers are invited to sign up for one of the Schedule Loss of Use Informational Webinars taking place this Wednesday, May 23.
The Board's Medical Director and Senior Policy Advisor, Elain Sobol Berger, MD, JD will provide training on the 2018 Impairment Guidelines' approach to assessing SLU permanent impairment. Case studies will demonstrate how to apply the SLU principles and objective criteria in making an SLU determination.
There will be two webinars, so you can register for the time that works best for you. Each webinar will last approximately one hour and will include time for questions and answers. When you click ‘register here’, you will be taken to a general information page. You must click ‘Register’ on the bottom of that page to sign up.
Wednesday, May 23, 8:30 a.m. - 9:45 a.m. Register here
Wednesday, May 23, 4:00 p.m. - 5:15 p.m. Register here
We will be sending an announcement on May 24 when the recorded version of this webinar is available on the Board's website at http://www.wcb.ny.gov/content/main/hcpp/ImpairmentGuidelines/ImpGuideOverview.jsp.
As part of the 2017 executive budget, Workers’ Compensation law §15(3)(x) required the Workers' Compensation Board to implement new Permanency Impairment Guidelines for Schedule Loss of Use (SLU) evaluations. The new 2018 SLU Guidelines took effect January 1, 2018.
For more information on the Schedule Loss of Use Guidelines, please see Subject No. 046-1011. The enabling regulation is set forth at 12 NYCRR 325-1.6, and is also available at the Board's website.