Administrative Policy effective January 1, 2020

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Medicaid Managed Care Claims Testing Opportunity for Children's Behavioral Health Services

We are conducting validation testing to help ensure successful submission of behavioral health claims in preparation for the Medicaid managed care children’s home and community-based services implementation on October 1, 2019. Our goal is to validate that business processes and technical changes required to support the transition are functioning appropriately to minimize modifications to claims processing. 

The following are key requirements that must be met in order to test with our Health Plan via electronic data interchange (EDI):
1. Ability to submit electronic institutional 837i test claims
2. Ability to receive and validate the 999, 277CA and NYSCOP transaction reports and corresponding data for all claims submitted in the        test files

If you will not be submitting claims using EDI, please provide your contact information for alternate submission of claims.

If you wish to test with us, please send an email to our Children’s Behavioral Health Provider Relations representative, Sarah Newsome at  Please use the following subject line in your email: Claims Testing CFTSS. Be sure to include contact information that contains a secure email address.

Please share this important information with all practice locations or corporate offices and anyone in your practice who should be aware.

We appreciate your collaboration, and we look forward to a successful implementation.  

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Behavioral Health

Claims and Billing