Reminder of operational enhancements to MLTC program

As has been previously communicated, operational enhancements to the Managed LongTerm Care (MLTC) program in New York will take effect March 1, 2025. The provider manual has been updated to reflect these enhancements.

Included in the changes:

• MLTC member ID numbers
• Electronic funds transfer (EFT): EnrollSafe replaced Payspan as the EFT website.
• Availity Essentials replaced Payspan for provider remittances (ERA).
• Authorizations for personal care services, social daycare, and meals will be issued in weekly units and will no longer contain a fixed daily schedule, allowing for greater flexibility in service provision and billing.
• Claims-related updates:
• Access claim status information in Availity Essentials.
• Paper claims submission address
• Aligned claim timely filing guidelines.
• Value code and rate code are required for nursing home claims.
• Bill types and revenue codes were aligned for specific service.
• Check run days were changed to Wednesdays and Saturdays.

What did not change:

• Authorization information is available on the legacy MLTC Provider Portal.
• Electronic claim submission — Payer ID 45302 for MLTC claims
• EDI claims submissions using Availity Essentials
• Claim dispute process
• Clinical appeal process
• The Care Management, Provider Services, and Provider Relations teams

If you have any questions about the changes, you may call our MLTC Provider Service Line at 929-946-6500 from 9 a.m. to 5 p.m., Monday through Friday.