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United Healthcare, Cigna and MVP Remittance Success – Providers Can See Results on EIBilling

 Dear Colleague: 


Effective today, Early Intervention (EI) billing providers no longer have to enter Explanation of Benefits (EOB) remittance data into the EIBilling system for United Healthcare, Cigna or MVP. PCG, the State Fiscal Agent (SFA),  working with the Department of Health (DOH), Department of Financial Services (DFS) and these three insurers, has created, tested and implemented a system of receiving, loading and reporting remittance data for claims made by EI billing providers for children covered by United Healthcare, Cigna and MVP. 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 $16 million of remittance data sent from United Healthcare, Cigna and MVP for claims paid April 1, 2013 through February 28, 2014.

United Healthcare, Cigna and MVP have now built the capabilities to generate and send the remit file to the SFA on a routine basis and the SFA 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 system from original claiming to complete adjudication, and payment from the escrow account for denied or partially paid claims.

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

Should EI billing providers have questions about United Healthcare, Cigna or MVP remittance data on EIBilling, they should contact the PCG Customer Services Center at 1-866-315-3747. 

DOH, DFS, and 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, Oxford, Empire BCBS of NY/Health Plus, Affinity, Fidelis, Independent Health and Hudson Health. DOH and SFA will provide updates on the completion of those remittance processes as they occur.

SFA also wishes to remind providers that they no longer have to enter EOB remittance data themselves into EIBilling.com. SFA is providing manual entry of this data to providers who wish to take advantage of this service. For more information about how to take advantage of this service, please click here.

Please do not reply to this e-mail announcement.

Thank You.

Article ID: 145, Created On: 3/20/2014, Modified: 10/28/2015

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