Group Pre-validation File

New York State Department of Health – Office of Health Insurance Programs
NY Medicaid EHR Incentive Program

The NY Medicaid EHR Incentive Program offers pre–validation services for eligible providers who would like program support to assist in validating their Medicaid Patient Volume before attesting.

Group providers may utilize the pre–validation services if they have determined the following information that they intend to submit with their attestation:

90–day reporting period for Medicaid Patient Volume
Medicaid encounter data
Total patient encounter data

Please complete this file and return to NY Medicaid by email to hit@health.ny.gov.

Organization Name:  
Organization NPI:  
Pre–validated Payment Year:  
Reporting Period Start Date:  
Reporting Period End Data:  
Group Medicaid Encounters:  
Group Total Encounters:  

Please take note of the following important information:

  1. If your organization bills under its providers individual NPI rather than the Organization NPI, NY Medicaid will require provider specific information. Please fill out the second tab of this excel document, titled "Provider Specific Information."
  2. All provider attestations are subject to audit. In the event of an audit, it may be necessary to produce documentation of all encounters included in the numerator or denominator. before using any data in this file for attestation, providers should verify that the "FFS Encounters" reported here match their records of fee-for-service claims paid by NY Medicaid. In the event of a discrepancy, providers should consult with their billing agency/department or the NY Medicaid EHR Incentive Program Support team for advice on how to properly use this data set for attestation.

    To contact the NY Medicaid EHR Incentive Program support team:
    hit@health.ny.gov
    1 (877) 646–5410, Option 2
Below is an explanation of the fields contained in this data set.
Organization Name: The name of the Organization that is requesting pre–validation.
Organization NPI: The National Provider Identifier (NPI) of the group practice or clinic reported as the Provider Group NPI (in the case of fee–for–service claims), Attending or Servicing/Rendering provider (in the case of managed care encounters), or the Billing NPI (in the absence of a group/clinic NPI appearing in the other fields).
Pre–validated Payment Year: The payment year the Organization wants to be pre–validated (e.g. 2015 or 2016).
Reporting Period Start Date: 90–day patient volume reporting period start date.
Reporting Period End Data: 90–day patient volume reporting period end date.
Group Medicaid Encounters: The number of Medicaid patient encounters attributable to the Organizational NPI on any given date of service during the 90–day patient volume reporting period according to the definition of "encounter" specified in the NY Medicaid EHR Incentive Program.

Please visit FAQ ID EP07 for the definition of an encounter.
Total Encounters: The number of total encounters attributable to the Organizational NPI on any given date of service during the 90–day patient volume reporting period.
Render Care Outside the Organization: Does the provider work at this Organization full–time or part–time. If the provider is part–time within the Organization please indicate ´Y´. ;