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Subrogation Notices - New Functionality on EIBilling.com

 

New York State Department of Health
New York Early Intervention System (NYEIS) Electronic Mailing List

Subrogation Notices – New Functionality on EIBIlling.com
 

 



Dear Colleague:


Pursuant to NYS Public Health Law (PHL) § 2559(3)(d), approved early intervention providers are subrogated to the rights an eligible child and his or her family may have or be entitled to from an insurer or health maintenance organization for services rendered by providers to the child and family that are covered under an insurance policy, plan or benefit package. Providers must submit notice to the insurer or plan administrator of their exercise of the right of subrogation upon the provider's assignment as the early intervention service provider for the child.  NYS Insurance Law § 3235-a(c) states that a right of subrogation exercised by a provider under PHL § 2559 is valid and enforceable against the insurer or health maintenance organization to the extent benefits are available under the insurance policy, plan or benefit package. The insurer or plan administrator must accept claims from an approved early intervention provider who has submitted prior written notice of intent to exercise subrogation rights for any early intervention services for which benefits are available to the insured child.

The Department’s interim fiscal agent, James McGuinness and Associates (McGuinness), has enhanced the functionality on its website, www.EIBilling.com, to enable providers to print subrogation notices, using the Department’s template, populated with children’s insurance information, for children: (1) to whom the provider is rendering services, and (2) either the child’s insurance coverage has been identified in NYEIS as subject to State insurance law OR parent consent has been provided to bill insurance, if the child’s and family’s insurance policy is NOT subject to state insurance law.

This functionality is immediately available for any child for whom the provider submitted bills in NYEIS during the first three weeks of April.  By close of business today, Thursday, May 9, 2013, this functionality will be available for ALL children whose records reside in NYEIS.  

For children whose records reside in the KIDS legacy system, insurance information will become available to populate the template as counties upload bills for children enrolled in KIDS and transmit files to McGuinness for claiming and payment purposes.  In addition, McGuinness has obtained insurance information for ALL children whose records reside in KIDS from the following counties:  Schenectady, Orange, Rockland, and Suffolk.  McGuinness is currently working with Westchester and Nassau Counties to upload child insurance information from KIDS.  

Please be reminded that insurance policy information is pulled from NYEIS and KIDS data and may not include all addresses associated with the child’s insurer.  If an insurer advises the provider to submit the subrogation notice to a different address, the provider should follow instructions supplied by the insurer.

McGuinness will accept full KIDS insurance data from any county.  Counties should contact McGuinness at CountySupport@EIBilling.com to obtain instructions to upload child insurance data to McGuinness.

McGuinness is adding screens into EIBilling.com to allow providers to view insurance information for children for whom the provider has service authorizations.  This functionality will be available in EIBilling.com by tomorrow, Friday, May 10, 2013.

Thank you.
 



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Article ID: 62, Created On: 5/9/2013, Modified: 10/28/2015

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