Built with the end-user in mind, the ePACES application has user-friendly navigation, data entry fields, comprehensive on-line help and pop-up boxes that encourage both speed and accuracy. Persistent navigational menus where the items are logically divided into functional groupings allow the user to quickly and easily move about the system. Entering claim information is made quick and simple with the addition of context-specific pop-up boxes which when used will display code values specific to the field in question, lessening the opportunity for incorrect codes being entered. In an effort to produce the highest possible percentage of payable claims, data integrity and simple field validations are performed as the user enters the claim.

To enroll in ePACES, providers will need the following:

• Computer with internet access
• Valid email address
• Internet browser that supports 128 byte encryption
• Operating systems: Microsoft Windows, Macintosh, or Linux
• NYS Medicaid Provider ID Number
• Electronic/Paper Submitter Identification Number

ETIN Applications and instructions are available at www.emedny.org, click on Provider Enrollment Forms in the Featured Links section of the home page. The ETIN application is located in the left-hand column.

Providers should contact the eMedNY Call Center at 1-800-343-9000 for more information on ePACES enrollment. Training for ePACES is available from eMedNY Regional Representatives. Quick reference documents are available in this section of the website to guide providers through ePACES usage.

ePACES Access Control

The ePACES application uses role-based security, which means that different users may have access to different sets of functions within the application based on their ePACES profile. The associations between users, functions and data are never direct. Roles are assigned to users. Functional groups will often define functionally common to specific user roles. For example, one user group may only enter claims while another may strictly process eligibility inquiries. In addition to role-based security, ePACES will restrict the access based on HIPAA transactions. Users will be able to access only the data associated the Provider Identification Numbers they have been authorized to work with. The ePACES application will give providers the ability to remotely administer and manage their users’ security.

Warning: As per the Health Insurance Portability and Accountability Act (HIPAA), eMedNY or the on-site ePACES Administrator is required to assign unique user ids and passwords for identifying and tracking user’s identity [Ref: § 164.312(a)(2)(i)]. Users that share their ePACES user id and password are in violation of the HIPAA Security Regulation. If this practice is detected, the user’s access will be revoked and other sanctions may apply.

ePACES performs the following transaction types:

1. Claims Status
2. Claims (Professional, Institutional and Dental)
3. Eligibility Requests
4. Prior Approval Requests, including Dispensing Validation System (DVS) requests

For Professional providers (Physicians, Nurses, Nurse practitioners and DME, etc.) claims can be submitted in “real-time”. Real time means that the status of the claim and any associated payment amount will be available to the provider within seconds. Please note that to take advantage of real-time submissions; the claim must not contain more that 4 lines (procedures).

Claim Status via ePACES

Providers can utilize ePACES to view the status of claims submitted regardless of the submission method. This means that providers can check on the status of claims (and the associated payment amount) for claims submitted via ePACES or any other method (electronic or paper). A great advantage of ePACES is the speedy availability of claim status. For claims submitted via ePACES (batch method), the status of the claim(s) is available usually on the same day the claim was submitted.

Automated scripting of the ePACES online access and entry process to eMedNY is forbidden

Warning: ePACES provides individuals the ability to create and submit transactions to eMedNY over the Internet using their browser. Collecting multiple transactions created in ePACES, and submitting these as batches is also supported. However, automated programmatic scripting of the ePACES online access and entry process to eMedNY is expressly forbidden, and will result in your user ID being revoked.

Scripting is a process of storing transactions in a computer file and programming the computer to enter them in rapid succession expecting online responses. This can create serious performance problems in ePACES and unnecessarily inconvenience other users of the product.

If you need information about automated interfaces to eMedNY, please visit our website: www.emedny.org , and select NYHIPAADESK. If you cannot locate the answer to your question(s), call the eMedNY Call Center at 800-343-9000.