Tag: #NYSIIS

Posted in Insurance, Training, Updates

EmblemHealth (NY) COVID-19 Vaccine and Monoclonal Antibody Infusions Policy

Posted on by KR2Medical Billing

Effective 11/09/2020 the following are the guidelines for COVID-19 Vaccine and Monoclonal Antibody Infusions for various EmblemHealth Product lines:

  1. Commercial Plans- EmblemHealth will cover the costs that are associated with administration of COVID-19 vaccines, for In-Network and Out-of-network providers, during the national public health emergency period. Reimbursement will be based on CMS published rates. NY state-specific rules may also apply: Please click here for a NY DOH COVID-19 vaccine presentation.
  2. Medicare Advantage Plans- charges for administrating the COVID-19 vaccine should be billed to your local MAC (Part B). The MAC will reimburse claims for Medicare members with no cost share for the remainder of 2020 and through 2021 If the provider will bill the claims to EmblemHealth the charges will be denied and the provider will be informed that the charges need to be submitted to the local Part B MAC. (If you are a provider located in NY the local Part B MAC is NGS- national government services).
  3. Medicaid Plans- EmblemHealth will cover costs that are associated with administration of COVID-19 vaccines, for In-Network and Out-of-network providers, during the national public health emergency period. NY state-specific rules may also apply: Please click here for a NY DOH COVID-19 vaccine presentation.

Partial List applicable to this reimbursement policy:

For the complete policy and the complete list of applicable codes, please click here to visit the policy.

Posted in In The Know Series, Insurance, MU Stage 2 and 3, My services, NY Medicaid EHR incentive program, Practice Fusion EMR, Training

Attesting to MU in New York State? Registered on NY DOH MURPH?….Well you also need to register with NYSIIS too!

Posted on by KR2Medical Billing

Background: (year 2016)

I started the attestation process for a SOLO SPECIALIST practice back in 2017. Program is NY Medicaid EHR incentive program, now CMS Promoting Interoperability Program, for the payment year 2016. (Attestation is the year after the payment year) Anyway, during the initial attestation process, in order to meet the MU, they ask you to register with the State or City , if you are located in the NYC, reporting registries; and transmit the information electronically utilizing the EHR you have at the practice.

OK, sounds simple enough. I went into the EHR (Practice Fusion) and followed their steps on how to get connected to ONLY NYSIIS, since the attestation is done for the specialist. Contacted the NYSIIS and after conducting a test connection with the Practice Fusion, the specialist was connected to TRANSMIT to NYSIIS immunizations given to the patients.

P.S. The specialist only transmits flu shots that are administered by the provider during each flu season.

Late 2017:

In October/November of 2017 the specialist received an email that ALL providers attesting to the NY Medicaid EHR Incentive Program have to register with MURPH. MURPH is Meaningful use Registration for Public Health. In that system the provider registers the INTENT to attest to MU and REPORT to the specialized registries.

Ok, done that!

Now let’s remember that the provider has been transmitting to NYSIIS through Practice Fusion ALL THIS TIME.

Fast forward to June 2018:

After registering now with Healthylink NY, which is another system, the provider now received an email from DOH stating that the specialist is not in the NYSIIS system and therefore needs to register in order to meet MU. WHAT?! This took me aback. I thought that maybe I have done something wrong. NOPE! I quickly went back to Practice Fusion and clicked to Settings, making sure that the provider IS connected to NYSIIS to transmit the Immunizations. Aha! The information is there in black and white! I take a screen shot of the information and send it to DOH. Thinking that the provider was all set.

To my surprise, the next day the provider receives another email regarding this matter informing her that she also needs to register DIRECTLY with NYSIIS in order to do the attestation for NY Medicaid EHR Incentive Program/ CMS Promoting Interoperability.

Lesson learned!

PCP’s should have access to NYSIIS, to report or look up vaccinations for the patients. However, for specialists that was optional, but signing up to transmit ( ex. flu vaccines) through your EHR was required.

Starting last year Providers (Specialists) need to register first on MURPH system AND starting in 2018 they need to register and obtain the NYSIIS registration number too!

Now don’t fret the registration is fairly easy and takes about 1 week.

After all said and done make sure to answer the email from DOH and give them that NYSIIS registration number, even if you already submitted your ATTESTATION on MIEPASS portal