EI-Hub Waivers
Update on Billing Edits
Dear
Colleagues,
The Bureau of
Early Intervention (BEI) has received multiple communications from
municipalities and providers regarding the waiver process in EI-Hub and the
related claims rejections. BEI has met with Public Consulting Group (PCG) and
determined that the Waiver Billing edits in the EI-Hub be temporarily relaxed
during the initial transition period of the of EI-Hub. This change will
decrease work volume for municipalities and providers.
While waiver
entries on the IFSP in the Case Management Component of EI-Hub are visible,
these are for informational purposes to indicate which services have a waiver
based on the agreed upon services for the child and family. While this
temporary change has been made, please be aware:
- This
is effective for claims submitted 11/1/2024.
- Providers
will not receive claims rejections related to the below waiver errors.
- Providers
will not need to enter a waiver in the Waiver Request panel.
- Providers
may rebill claims for all dates of service which have been submitted in
EI-Hub and rejected for the errors below.
- Municipalities
are not required to review the Waiver Submission dashboard to approve
waivers.
- Existing
waivers will remain in EI-Hub.
- IFSPs
will continue to generate waivers where applicable, and the decision will
be shown in the Waiver panel when the EIO/D reviews the service on the
submitted IFSP however no further action on the waiver is needed in the
EI-Hub at this time.
- BEI
and municipalities continue to have the ability to review billing
practices for appropriate billing of services. Reports in the case
management and billing portals in the EI-Hub can be utilized to review
claims.
|
Status
Codes
|
Entity
Codes
|
Category
Codes
|
Short
Description
|
EM-Error
Message
|
|
612
|
F36
|
A3
|
No
Waiver approved
|
Exceeds
Basic Home & Community Based Visit limit; 3/Day; No Waiver approved
|
|
612
|
F37
|
A3
|
No
Waiver approved
|
Exceeds
Extended Home & Community Based Visit limit; 3/Day; No Waiver approved
|
|
612
|
F38
|
A3
|
No
Waiver approved
|
Exceeds
Basic Home & Community Based Visit limit; 1/Day/Discipline; No Waiver
approved
|
|
612
|
F39
|
A3
|
No
Waiver approval
|
Exceeds
Extended Home & Community Based Visit limit; 1/Day/Discipline; No Waiver
approved
|
|
612
|
F40
|
A3
|
No
Waiver approved
|
Exceeds
Basic & Extended Home & Community Based Visits limit; 3/Day; No
Waiver approved
|
|
612
|
F41
|
A3
|
No
Waiver approved
|
Exceeds
Basic & Extended Home & Community Based Visits limit;
1/Day/Discipline; No Waiver approved.
|
|
612
|
F42
|
A3
|
No
Waiver approved
|
No
more than 1 Office/Facility Visit per Discipline per Day
|
|
612
|
F43
|
A3
|
No
Waiver approved
|
Exceeds
Office/Facility Visit Limit; 3/Day; No Waiver approved.
|
|
612
|
F44
|
A3
|
No
Waiver approved
|
Exceeds
Parent/Child Group Visit Limit; Max 1/Day; No Waiver approved
|
|
612
|
F45
|
A3
|
No
Waiver approved
|
Exceeds
Family/Caregiver Visit Limit; Max 2/Day; No Waiver approved
|
|
612
|
F46
|
A3
|
No
Waiver approved
|
Exceeds
Group Developmental Visit limit; Max 1/Day; No Waiver approved
|
BEI and PCG
remain committed to ensuring the success of the EI-Hub. If you have any
questions about this message or the waiver process, please reach out to the PCG
Call Center at 866-315-3747 or by using the Web-to-Case feature, accessible
under the 'Help' section (blue menu bar) in the EI-Hub or on the Learning
Management System (LMS) under ‘Quick Links’
Saturday, November 2, 2024 1:52 PM