Use of Delay Reason Code Three (3)
The use of delay reason code three
is for authorization delays that were previously approved by the state and must
be submitted within thirty (30) days from the date of notification.
When approval is granted to use
delay reason code three, providers must resubmit the affected claims from their
Workable Claims queue in EI Billing with the delay reason code 3 selected
within 30 days of the notification. The claims will then be pended by Medicaid
awaiting the following documentation be sent to the Department of Health within
60 days from the date of claims resubmission:
- Copy of dated communication from Bureau of Early
Intervention (BEI) stating authorization to utilize delay reason code
three.
- A listing of all 16-digit TCNs that are pended
at Medicaid for use of this delay reason code.
The correspondence can be sent to:
New York State Department of Health
Attn: Medical Pended Claims
1 Commerce Plaza, Room 1206
Albany, NY 12260
Note: After 60-days,
if the documentation is not received, Medicaid will deny all claims CO-29 for
timely filing.
Article ID: 491, Created On: 4/5/2024, Modified: 4/5/2024