Stop Loss Resources
Manual
The Stop Loss Policy and Procedures Manual is posted on the eMedNY website: Stop Loss Manual
Note: by selecting this link, you will be opening the Provider Manuals section of the eMedNY website in a new tab.
CSC Support - eMedNY
CSC PROVIDER SERVICES
(800) 343-9000 (OPTION 3, THEN OPTION 4)
- www.eMedNY.org
This site contains a wealth of information. There are links to the monthly Medicaid Update, NYHIPAADESK, and recommended Vendors for software issues. - TECHNICAL SUPPORT
Provides information on e-Paces and for batch submissions for eligibility checks through eXchange.
Large numbers of eligibility transactions, referred to as 270 transactions are available. - REMIT STATEMENTS
Make sure you have access to the REMIT statements that are sent to every Plan. These statements contain valuable information about the status of your claims.
NYS DOH WEBSITES
- Contains valuable information concerning rates, SIWs, Letters to Health Plans, links to nursing home rates, calculation sheets, a complete list of all health care facilities in New York, including OPCERT numbers.
All Patient Refined Diagnosis Related Groups (APR-DRGs)
Nursing Home Rates - Health Commerce System
- Secure website for the NYS Department of Health.
Requires an account and password in order to access the site.
Call 866 529-1890 to set up an account
Useful Links:
- HARP Stop Loss claims Phase-In 2016-2018: Overviews the three-year phase in of the HARP Stop Loss Claims process
- July 2015 Special Edition Medicaid Update - Behavioral Health
- Medicaid Reform Rates This page provides categorized rate information for APG and APR-DRG rates. Rate information is defined on the left-side navigation bar.
- If you would like to receive the Medicaid Update Newsletter, send your request to: medicaidupdate@health.ny.gov
- Nursing Home Rates This page provides categorized rate information for long-term care facilities. Rate information is defined on the left-side navigation bar.
- SIWs December 2009 - Present