*This communication is to provide guidance regarding an issue reported by EI Billing Providers that bill EI services to the insurance payer GHI*

GHI underwent a systems update on October 22, 2015 that resulted in some EI claims for non-participating EI Billing Providers (providers that do not have a contract with GHI) to issue checks or electronic remittance in the rendering provider’s name. GHI became aware of the issue, and it was corrected on November 5, 2015.

GHI is still gathering information regarding the full impact of this error, but to-date several EI Billing Providers have reported the issue. PCG is working with BEI, the Department of Financial Services (DFS), and GHI to identify all checks issued with the rendering provider as payee.

If you received a check(s) from GHI with the rendering provider as payee, but were able to successfully deposit it, you do not need to take any further action.

If you received a check(s) with the rendering provider as payee, but have not deposited it yet, please report the issue to PCG AND the DFS as soon as possible:

·         The PCG Customer Service Call Center can be reached at (866) 315-3747

·         To file a complaint with DFS, go to http://www.dfs.ny.gov, click on “File a Complaint”, and use the Consumer Complaint Form (be sure to include specific claim information)

Once you report the issue, GHI will be able to stop payment and reissue the checks.

If you experience a similar issue with insurance payments in the future, please alert PCG via the Customer Service Call Center, and follow the steps above to file a complaint with DFS. This is the fastest way for the issue to be resolved, and for you to receive payment.

Article ID: 298, Created On: 11/25/2015, Modified: 11/25/2015