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Excellus Remittance Success – Providers Can See Results on EIBilling

 

Dear Colleague:

Effective today, early intervention (EI) providers no longer have to enter EOB remittance data into the EIBilling system for Excellus. PCG, the State Fiscal Agent (SFA) working with DOH, DFS and Excellus, has created, tested and implemented a system of receiving, loading and reporting remittance data for claims made by EI providers for children covered by Excellus. This will improve the ability of providers to receive timely payments and reduce manual data entry by providers.

The SFA has received, loaded and reviewed more than $1.1 million of remittance data sent from Excellus for claims paid between April 1, 2013 through December 7, 2013. SFA is currently loading new files just received from Excellus through January 27, 2014.

Excellus has now built the capabilities to generate and send the remit file to the SFA on a weekly basis and PCG is ready to accept and post these files when received. The increased frequency of  sending and receiving these files will improve the overall payment cycle and move claims faster through the SFA from original claiming to complete adjudication, and payment from the escrow account for denied or partially paid claims.

Providers will be able to review the remittance data for claims for services to children covered by Excellus on EIBilling.com.  Although not recommended to avoid duplicate data, providers will have the ability to continue to enter Excellus remittance information from paper EOBs via EIBilling.com for a limited time.

As a result of loading these files, the SFA has found a number of payment issues and will work with affected providers and Excellus to resolve some of the discrepancies it found.

Should providers have questions about Excellus remittance data on EIBilling, they should contact the Customer Services Center at 1-866-315-3747.

DOH, DFS, and the SFA continue to work with other insurers to obtain, review and load remittance data. PCG is currently receiving and reviewing remittance files from other major insurers including, Emblem, Empire BCBS of NY/Health Plus, MVP and Cigna. DOH and the SFA will provide updates on the completion of those remittance processes as they occur.

Please do not reply to this e-mail announcement.

Thank You.


Article ID: 139, Created On: 2/7/2014, Modified: 10/28/2015

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