If your agency currently submits claims manually via NYEIS and will be using Service Logging to submit claims in the EI-Hub, it is crucial to understand the following to ensure uninterrupted billing once the EI-Hub is formally launched on October 15, 2024.
Entities currently submitting claims manually in NYEIS will be transitioned to the EI-Hub Service Logging module for billing and claiming. The EI-Hub Service Logging module enables entities to enter claims and bill for services delivered by their employed or contracted rendering providers. To facilitate this for your agency, all rendering providers must have a Health Commerce System (HCS) account and an EI-Hub Case Management user role to become active and available for selection on Service Authorizations in the Service Logging module. This account setup is required for entities to enter claims and bill for services delivered by their rendering providers. We recognize that this represents a deviation from prior communications and apologize for any resulting confusion. Due to the security measures and validation protocols within the EI-Hub, HCS accounts are required to bill for services provided by all rendering providers of entities through the Service Logging component.
If any rendering providers at your agency do not have an HCS account, it is crucial to establish one.
- For rendering providers without an active HCS account by the transition date (10/4):
- Accounts for these providers will not be automatically created in the EI-Hub. These providers need to obtain an HCS account before the launch of the EI-Hub on 10/15.
- To enable billing, each rendering provider must log into the EIHub following the formal system launch (10/15) using their HCS ID, and the agency must assign the appropriate Case Management user role(s) (RenderProvNY, JrRenderProvNY, or ISC/OSC NY). Completing these account set-up steps will enable agencies to enter claims and bill for services delivered by their rendering providers.
- For rendering providers with an active HCS account but do not have a NYEIS user role before the transition (10/4):
- Accounts for these providers will not be automatically created in the EI-Hub. Additionally, they are not required to obtain a NYEIS user role before the transition to the EI-Hub on 10/4.
- To enable billing, each rendering provider must log into the EIHub following the formal system launch (10/15) using their HCS ID, and the agency must assign the appropriate Case Management user role(s) (RenderProvNY, JrRenderProvNY, or ISC/OSC NY). Completing these account set-up steps will enable agencies to enter claims and bill for services delivered by their rendering providers.
- For rendering providers with an active HCS account and an active NYEIS user role before the transition (10/4):
- These providers will have their information automatically migrated to the EI-Hub and agencies can enter claims and bill for services delivered by their providers immediately after the system launch (10/15). No further action is required.
Immediate action is required if your rendering providers do not have an HCS account. Please instruct your rendering providers to follow the instructions below to obtain an HCS account: - Instructions for Rendering Providers with a professional license – Rendering providers with a professional license can register for an account on their own if they have an NY license/state ID.
- This includes: Audiologist, Certified Dietician/Nutritionist, Certified Behavior Analyst Assistant, Licensed Behavior Analysts, Licensed Practical Nurse, Medicine (Physician), Nurse Practitioner, Occupational Therapist, Occupational Therapist Assistant, Optometrist, Physical Therapist, Physical Therapy Assistant, Psychologist, Registered Physician Assistant, Registered Professional Nurse, Social Worker (LCSW), Social Worker (LMSW), Speech- Language Pathologist, Licensed Creative Arts Therapist, Licensed Marriage and Family Therapist, Licensed Mental Health Counselor, and Licensed Psychoanalyst.
- Instructions for Rendering Providers without a professional license – Rendering providers without a professional license will require assistance from an agency to establish an HCS account.
- This includes: Certified Low Vision Specialists (certified by the ACVREP), Orientation and Mobility Specialists (certified by the ACVREP), Vision Rehabilitation Therapists (certified by the ACVREP), Registered Dietitian, Teachers of Special Education, Teachers of Students with Disabilities - Birth to Grade Two, Teachers of the Blind and Partially Sighted, Teachers of the Blind and Visually Handicapped, Teachers of the Blind and Visually Impaired, Teachers of the Deaf and Handicapped, Teachers of Deaf and Hearing Impaired, Teachers of the Deaf and Hard of Hearing, Teachers of the Speech and Hearing Handicapped, Teachers of Students with Speech and Language Disabilities.
- More information on obtaining an HCS account.
Anticipated Questions: - Q: I (the agency) have assisted all rendering providers to obtain an HCS account. Is there anything else that either the rendering providers (or) the agency need to do in order to bill on their behalf?
- A: Yes, additional steps are required. Obtaining an HCS account alone will not enable agencies to bill on behalf of their rendering providers, as the connection between HCS and the EI-Hub has not yet been established. Rendering providers will need to use their HCS account information to log into the EI-Hub when the system formally launches on October 15. After the rendering provider has successfully logged into the EI-Hub, the agency’s role administrator can assign the necessary CM user role(s). These steps link a therapist’s profile with the individual as part of the security and user validation process between HCS and the EI-Hub. Completing these two actions will establish the required connections within the system, enabling the agency to bill on behalf of their rendering providers.
- Q: Some of our rendering providers work for multiple agencies, will they need more than one (1) HCS account?
- A: No, rendering providers only need one (1) HCS account. Rendering providers will only need to coordinate with one agency (as needed) to obtain an HCS account.
- Q: Can we (the agency) remove EI-Hub access for our rendering providers and still bill on their behalf?
- A: No, once a user's EI-Hub Case Management role is removed, they will no longer appear in Service Logging and agencies will not be able to bill on their behalf.
- Q: Will rendering providers with the aforementioned account setup be able to create claims?
- A: No, users will not have access to the Service Logging module by default; it must be configured manually. Unless an agency configures their rendering providers with the Service Logging module, they will not be able to generate claims.
- Q: Will rendering providers with the aforementioned account setup be able to access Case Management?
- A: Yes, rendering providers with this setup will be able to access Case Management. They can view data only for children assigned to their caseload and their personal therapist profile. They will not have access to financial data for the agency.
If an agency prefers that their rendering providers do not use Case Management, they are not required to do so. Agencies can continue to use data entry staff to input information into Case Management on behalf of their rendering providers.
Have Questions? For questions regarding obtaining a Health Commerce System (HCS) account, please contact the Commerce Accounts Management Unit (CAMU) at 1-866-529-1890, Mon-Fri, 8:00 AM – 4:45 PM.
For questions regarding the EI-Hub and/or configuring user roles, please contact the PCG Call Center at 866-315-3647, Mon-Fri 7:00 AM – 7:00 PM.
Article ID: 516, Created On: 9/23/2024, Modified: 9/23/2024