Medicaid - Guidance Documents

ADM and GIS Messages

Clinic

Durable Medical Equipment (DME)

Durable Medical Equipment (DME) Provider Communications

eMedNY

Enteral

Family Planning Benefit

Medicaid Reference Guide (MRG)

Medicaid Update

New York Partnership for Long Term Care

Office of Alcoholism & Substance Abuse Services (OASAS)

Office of Mental Health

NYS Office of Mental Retardation and Developmental Disabilities (OMRDD)

Ownership

Provider

Provider Billing and Policy

Provider HIPAA Instructions

HIPAA

HIPAA Companion Guide

eMedNY Transaction Information Standard Companion Guide X12

The eMedNY Transaction Information Standard Companion Guide X12 contains information on the following:

  • Health Care Claim: Institutional (837)
  • Health Care Claim Professional (837)
  • Health Care Claim Dental (837)
  • Health Care Services Review Request for Review and Response (278)
  • Health Care Claim Acknowledgment (277)
  • Payroll Deducted and Other Group Premium Payment for Insurance Products (820)

eMedNY Transaction Information Standard Companion Guide CAQH - CORE CG X12

The eMedNY Transaction Information Standard Companion Guide CAQH - CORE CG X12 contains information on the following:

  • Health Care Eligibility Benefit Inquiry and Response (270/271)
  • Health Care Claim Status Request and Response (276/277)
  • Health Care Claim Payment/Advice (835)

eMedNY Trading Partner Information Standard Companion Guide

The eMedNY Trading Partner Information Standard Companion Guide replaces information previosly found in these gudies:

  • Supplementary Document for Taxonomy Usage
  • Technical Supplementary Companion Guide

NCPDP D.0 Companion Guide

The NCPDP D.0 Companion Guide replaces information previously found in these gudies:

  • National Council for Prescription Drug Programs (NCPDP) Companion Guide
  • National Council for Prescription Drug Programs (NCPDP) Companion Guide

5010 Sample Files

We provide 5010 Sample Files of the following:

  • 271 Sample (Eligible)
  • 277 Sample (In response to a 276 Claim Inquiry)
  • 277CA Sample (Accepted)
  • 277CA Sample (Rejected)
  • 278 DVS Response Sample
  • 278 PA Response Sample
  • 999 Sample (Accepted)
  • 999 Sample (Rejected)
  • TA1 Sample (Rejected)

Provider HIPAA Letter

Provider Manual

Transportation

Traumatic Brain Injury (TBI)