Doc ID: n00001702
To: ADHCC Members
From: Christine M. Fitzpatrick, Executive Director
Route To: Administrators, Chief Financial Officers
Date: 1/17/2008
January 17, 2008
Doc ID: n00001702
To: ADHCC Members
From: Christine M. Fitzpatrick, Executive Director
Route To: Administrators, Chief Financial Officers

MEMORANDUM

SUBJECT:  ADHC Transportation Rate Codes
ABSTRACT:  Alerts members to a problem billing transportation rate codes under Method 1.
As members are aware, effective January 1, 2008, adult day health care programs (ADHC) that selected Method 1 as their means of transporting registrants were to begin billing eMedNY two assigned rate codes. These codes are 3833 for a round trip to an ADHC program and 3834 for a one-way trip. Billing these codes should result in the ADHC program being reimbursed the region-specific rate negotiated for ADHC transportation.

The ADHCC has learned that there is an edit in the eMedNY computer program that results in the transportation claim being denied. The problem is not with the codes listed above; it is with an edit in the eMedNy computer program. The Department of Health is aware of the problem and is working to correct it.

Members that have already submitted transportation claims do not have to resubmit them. Once the problem is addressed, Computer Sciences will automatically run the denials and pay the claims appropriately. Members also have the option to submit new claims using the assigned rate codes above, even though they currently will be denied. Again, once the system is fixed, CSC will automatically run all of the denials and pay them appropriately.

The ADHCC is well aware of the problem this will cause members. We are addressing it with the DOH and will advise members when this problem has been solved.

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