Unintended consequences of NYS Early Intervention Payment Policies

We received this email from the NYS Bureau of Early Intervention today. I would like to advise providers as well as the Bureau of the potential unintended consequences of this policy Dear Colleague: The Bureau of Early Intervention has recently received numerous inquiries regarding agreements being sent to EIP providers by insurers or insurer clearinghouses in response to claims submitted for EIP services. The agreements ask EIP providers to accept claim amounts proposed by the insurer as payment in full from the insurer for the claim which are lower than the State-established EIP rate.This is to advise EIP providers that providers should sign and return these agreements to insurers as requested. The agreement is specific to each claim. The interim State Fiscal Agent, McGuinness, is tracking all reimbursement from insurers to individual providers. The balance owed to EIP providers who receive a payment less than the State-established rate for EIP services from insurers will be included in Key Bank payment files and reimbursed through the escrow account.Please note that the language in insurer payment agreements which states that the provider must accept the insurer’s payment as payment in full does not apply to payments from the escrow account. Nothing in this language prohibits payment to the provider by the municipality from the escrow account. However, it is recommended that prior to signing and returning the agreement to the insurer, providers cross ...
Source: ABC Therapeutics Occupational Therapy Weblog - Category: Occupational Therapists Tags: health insurance OT practice Source Type: blogs