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2 Section II - Instructions for Obtaining Prior Approval. 3 Prior Approval Form eMedNY 361502. 4 Section III - Field by Field eMedNY 361502 Instructions. A supply of the new Prior Approval forms is available by contacting CSC at the number above. This section of the manual describes the preparation and submission of the New York State Medical Assistance Title XIX Program Order/Prior Approval Request Form eMedNY 361502. 5 Version 2008 1 5/8/08 Pa.

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Claims for payment for medical care, services or supplies furnished by any provider under the medical assistance program must be initially submitted within 90 days of the date the medical care, services or supplies were furnished to an eligible person to be valid and enforceable against the department or a social ...

Generally speaking, providers in New York State Medicaid program have to submit their claims for reimbursement within 90 days after the date of service unless special circumstances apply.

Note: All planned, elective inpatient service requests require prior authorization.

By Phone: (800) 541-2831. By e-mail: 1095B@health.ny.gov. By mail: NY State of Health, P.O. Box 11774, Albany, NY 12211.

Member IDs are assigned by NYS Medicaid and are composed of 8 characters in the format AANNNNNA, where A = alpha character and N = numeric character as shown in Exhibit 2.4. 2-2. Use this box to indicate Automobile No-Fault.

Claims Submission Professional service providers may submit their claims to NYS Medicaid using electronic or paper formats. Providers are required to submit an Electronic/Paper Transmitter Identification Number (ETIN) Application and a Certification Statement before submitting claims to NYS Medicaid.

You may apply for Medicaid in the following ways: Through NY State of Health: The Official Health Plan Marketplace. Through a Managed Care Organization (MCO) Call the Medicaid Helpline (800) 541-2831. Through your Local Department of Social Services Office.

Each month in which you need Medicaid services, bring in, send or fax (if available in your county) your paid or unpaid medical bills to your local department of social services. Only send these bills when they are equal to or more than the amount of your excess income.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232