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NEW YORK STATE MEDICAID PROGRAM - …

NEW york STATE MEDICAID PROGRAM COMPREHENSIVE MEDICAID CASE MANAGEMENT (CMCM) BILLING GUIDELINES CMCM Billing Guidelines Version 2004 1 Page 1 of 48 TABLE OF CONTENTS Section I - Purpose Statement .. 2 Section II Claims Submission .. 3 Electronic 3 Paper Claims .. 7 Billing Instructions for CMCM 10 Section III Remittance Advice .. 25 Electronic Remittance Advice .. 25 Paper Remittance Advice .. 26 CMCM Billing Guidelines Version 2004 1 Page 2 of 48 Section I - Purpose Statement The purpose of this document is to assist the provider community in understanding and complying with the New york STATE MEDICAID (NYS MEDICAID ) requirements and expectations for: Billing and submitting claims.

Pursuant to the Health Insurance Portability and Accountability Act (HIPAA), Public Law 104-191, which was signed into law August 12, 1996, the NYS Medicaid Program adopted the HIPAA-compliant transactions as the sole acceptable format for electronic claim submission, effective November 2003.

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