The Bureau of Early Intervention (BEI),
with the assistance of PCG, will be taking steps to pay EI Billing Providers
for claims submitted to Medicaid for the period April 1, 2013 to October 31,
2016 and denied for coordination of benefits (CO-22) for children no longer
active in the Early Intervention Program (EIP). The basis for this denial is the
child was covered by commercial insurance that was unknown to the EIP and not
billed as required prior to submission of claims to Medicaid.
BEI recognizes that EI Providers cannot
address missing commercial insurance information in situations where a child’s
case is closed. For a child to be deemed inactive in the EIP for the purposes
of these payments, the child must either:
- Have turned three (3) years of age on or before January
1, 2017 and are no longer age-eligible for EIP; or
- Be closed from the program and have an inactive IFSP
Claims with a Medicaid CO-22 denial
that meet either of these criteria will be paid out of escrow. Payment of these
claims through the escrow account will ensure the claims can be included in the
Medicaid retroactive claiming process.
During the week of February 13, 2017, PCG
will send an invoice to each municipality for these claims. The invoice is due
on February 23, 2017, and PCG will
complete the escrow payout on March 2. This process will be identical to how
special payments have been handled previously.
If you have any questions, please
contact the PCG Customer Services Center at (866) 315-3747.
Article ID: 348, Created On: 2/15/2017, Modified: 2/15/2017