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 February 28, 2019 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for children no longer active in the Early Intervention Program (EIP).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 is 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 EIP 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, 2019 and are no longer age-eligible for EIP; or
- Be closed from the EIP and have an inactive IFSP
Claims with a
Medicaid CO-22 denial that meet either of these criteria will be paid out of
escrow.
PCG will
complete the escrow payout during the week of June 10, 2019. Providers can
check their Medicaid CO-22 denials in “Medicaid Claims Needing Attention” in EI
Billing.
It is the
Department’s expectation that EI providers will continue to work with service
coordinators and municipalities to actively pursue commercial insurance
information for children actively enrolled in the EIP.
If you have any
questions, please contact the PCG Customer Service Center at (866) 315-3747.
Article ID: 409, Created On: 5/30/2019, Modified: 5/30/2019