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CO-22 Municipality Notice - November 2018

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to Medicaid for the period April 1, 2013 to April 30, 2018 and denied for coordination of benefits (CO-22) for children no longer active in the Early Intervention Program (EIP).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 September 1, 2018 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 October 29, 2018, PCG sent an invoice to each municipality for these claims. The invoice is due the week of November 5, 2018, and PCG will complete the escrow payout on during the week of November 12. 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: 391, Created On: 10/30/2018, Modified: 10/30/2018

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