Medicaid 90-Day Claiming Limit Enforcement

The New York Medicaid system (eMedNY) has implemented additional edits to enforce timely filing of claims. The most critical change is a strict enforcement of the 90-day claiming limit, with more restrictive application of the exception code 11. DOH has posted a slide presentation used during a recent training program on the new edits. This presentation and more details on timely filing of claims are available on the eMedNY website under Timely Billing Information. With these new edits in place, this is a good time for all Medicaid billers to review internal policies and procedures to ensure compliance with current timely filing requirements.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827