EIP Billing and Claiming Q&A - Updates on EIP Billing and Claiming Thursday, June 27, 2013

Sep 15, 2026

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Q&A session addressing updates to EIP billing and claims processing, focusing on how “system approved” status works within NYEIS invoice edit checks and what happens when insurer payments are denied or partial. Coverage explains escalation paths for non-covered or balance-due amounts via ISFA and escrow-funded payments, plus guidance on subrogation letters, Medicaid vs. managed care submission needs, and provider follow-up. Additional sections clarify tracking and remittance visibility through EIBilling.com reports and steps to obtain EIBilling access credentials.

LanguageEnglish

CategoryInvoices

FormatPDF

Pages5

Reading Time2 min

AccessFree to download

Q&A Session for Updates on EIP Billing and Claiming

Claim status and “system approved” meaning

Subrogation letters and Medicaid submission rules

Claim tracking, remittance details, and EIBilling reports

Resolving Medicaid data errors and resubmission workflow

Getting EIBilling login credentials

Q&A Session for Updates on EIP Billing and Claiming Thursday, June 27, 2013 Q: Will our agency get reimbursed for all the claims with NYEIS "system approved" status by the escrow account, if commercial insurance/Medicaid denies the payment? How can we tell in NYEIS at what point a claim is at if it only says “system approved?” "System Approved" is the status of a claim when it has passed all of the NYEIS invoice edit checks. This status indicates the invoice has been approved by the NYEIS system. These general service claims are extracted from NYEIS and sent forward to the State's Fiscal Agent for processing. In the event that payment from the insurer is denied for reasons beyond the provider’s control or payment is made in an amount less than the state early intervention rate for the service provided, the Interim State Fiscal Agent (ISFA) will process payments for the non‐covered claims or for the balance due the provider for the claims that were partially paid by insurance. Any claims which are denied by an insurer for reasons beyond the provider’s control (e.g., lack of medical necessity, service not covered, visit limits, or service caps reached) will be paid from an escrow account using municipal funds at State established rates for the EIP. Claims status information is available on [EiBilling.com](EiBilling.com). Q: We received a subrogation letter returned as undeliverable. What is the next step? Contact the Insurance Company and ask for the correct address for mailing the subrogation. Q: Do we need to submit subrogation to Medicaid Managed Care? No. You do not need to submit subrogation for children enrolled in Medicaid or Medicaid managed care. Q: Will we need to send more than one letter of Subrogation for each child? No. One subrogation notice per child should be sent. Q: Once we send the insurance company the subrogation letter how do we confirm they have received it? Providers are not required to confirm that insurers have received the subrogation notice, but may contact the Insurance Company directly. Q: If there is a Medicaid denial for an error, such as a date of birth, will the provider receive a copy of an EOB so that the claim can be resubmitted to Medicaid rather than being paid from the escrow? Prior to submitting claims to Medicaid, McGuinness is verifying child Medicaid data with eMedNY (CIN, name, DOB, etc. ) . For any mismatched information, McGuinness has produced a Medicaid Error Report for providers and municipalities. If the name mismatch is a simple change, such as Johnnie to John, the provider can make this change in EI Billing and resubmit the claim. They should still follow‐up with the municipality to correct the name in the source data (NYEIS or KIDS) . If the mismatch is CIN, DOB, or the name is completely incorrect, the provider needs to work with the municipality to have them correct the information in the source data system (NYEIS or KIDS) . When the source data is updated, that information is transmitted to the ISFA who will again verify the information with eMedNY and if correct (no mismatches), the claims will be submitted to Medicaid. No other action is needed on the provider’s part. Q: In [EIBilling.com](EIBilling.com) the claim status screens do not depict any Medicaid or Insurance claim submitted dates, denials, or other information. Is this the case with all providers and, if so, when will this be corrected? The ISFA has populated EIBilling reports with additional information to assist providers in tracking claim status and payment. Q: When we receive a check for payment from Medicaid will we receive a remittance of what child and dates of services were paid? Remittance information for Medicaid is available on [EIBilling.com. When](EIBilling.com. When) providers log on to EIBilling, their dashboard has selections under “Reports” for “Claims In‐Process” and “Claims Status.” Theseselections show how much money is in each claiming process (Insurance, Me

FAQs

What does “system approved” mean for an NYEIS claim?

“System approved” indicates the claim passed all NYEIS invoice edit checks and was approved by the NYEIS system. General service claims are then extracted and sent to the State’s Fiscal Agent for processing.

If an insurer denies payment or pays less than the early intervention rate, how are remaining amounts handled?

When payment is denied for reasons beyond the provider’s control or when payment is less than the state early intervention rate, the Interim State Fiscal Agent (ISFA) processes non-covered claims or the balance due. Payments come from an escrow account using municipal funds at state established rates.

How can providers track claim and payment progress and view remittance information?

Remittance information for Medicaid is available on EIBilling.com. After logging in, providers use dashboard report selections like “Claims In-Process” and “Claims Status,” and can view billing history and invoice batch details by clicking into individual claims or invoice records.

Sep 15, 2026

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