Accessing Your New York Medicaid Claims Information

New York Medicaid Members can obtain copies of their Medicaid payment records directly or to authorize the release of their records to a third-party, usually legal counsel, by following this link.

If you are a New York Medicaid member and have had a claim in the past 2 years, you can now view your medical claims on a third-party application.

The ability to view claims on a third-party application is part of the the Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access final rule.

How do I access my Medicaid claims information?

  • Follow this link for a list of the third-party applications that can provide Medicaid claims information to current Medicaid Members.
  • Complete the registration process. This will require you to have an existing NY.Gov ID and password, which can be done at My NY.Gov ID prior to registering with the application
  • Follow the directions on the third-party application to connect to your health plan
  • Provide your consent to share your health information with the selected third-party application
  • Report any problems directly to the selected third-party application

Is my Medicaid claims information private and secure?

Medicaid will never share your data with a third-party application without your express permission. However, once you allow your data to be shared with a third-party application, Medicaid is no longer responsible for the privacy and security of that data.

If you would like to use a third-party application, you will be requesting and authorizing the New York State Department of Health (NYS DOH) to share with the third-party application your protected health information. The third-party application you select would access and store your information, such as:

  • Personal details such as your name, address, phone number, email, and date of birth
  • Information about your insurance plans such as coverage type and Client Identification Number (CIN)
  • Explanation of benefits, including diagnosis, procedure codes, and insurance payments made on your behalf and the amount you paid
  • List of providers and organizations involved in your care delivery

This information shared may include or may infer certain sensitive information such as sensitive diagnosis codes, Mental health status, Pregnancy information, Abortion, AIDS/ARC, Alcohol and substance abuse, Behavioral health, Domestic violence, Genetic testing, HIV, Physical abuse, Reproductive health, or Sexually transmitted infections. This consent is valid as long as you continue to use the third-party application. Payment or coverage of services (other than the services available in the third-party application) will not be affected if you refuse to sign this consent.

You have the right to share your health information with a third-party application, but there may be risks. Once a third-party application has accessed your data, it is no longer protected by federal and state privacy laws such as HIPAA, may be re-disclosed by the third-party application and NYS DOH is no longer responsible for the privacy and security of the data. Instead your information would be protected by the Federal Trade Commission (FTC), which simply protects against deceptive acts such as if a third-party application shares personal data without permission when its privacy policy says it will not.

This is why it is important to take an active role in protecting your health information by understanding the privacy and security policies for any third-party application you choose to access your data. Be sure to review the third-party application or website's Privacy Policy and Terms and Conditions to fully understand how they will handle your data. You should look for an easy-to-read privacy policy that clearly explains how the third-party application will use their data. If a third-party application does not have a privacy policy, you can decide to not to use that third-party application.

When reviewing a third-party application, you may want to consider these questions:

  • Will this third-party application collect non-health data from my device, such as my location?
  • Will my data be stored in a de-identified or anonymized form?
  • How will this third-party application use my data?
  • Will this third-party application disclose my data to third parties?
    • Will this third-party application sell my data for any reason, such as advertising or research?
    • Will this third-party application share my data for any reason? If so, with whom? For what purpose?
  • How can I limit this third-party application's use and disclosure of my data?
  • What security measures does this third-party application use to protect my data?
  • What impact could sharing my data with this third-party application have on others, such as my family members?
  • How can I access my data and correct inaccuracies in data retrieved by this third-party application?
  • Does this third-party application have a process for collecting and responding to user complaints?
  • If I no longer want to use this third-party application, or if I no longer want this third-party application to have access to my health information, how do I terminate the app's access to my data?
    • What is the app's policy for deleting my data once I terminate access?
  • How does this third-party application inform users of changes that could affect its privacy practices?

Whether or not to utilize these services and the choice of a third-party application is yours alone. New York Medicaid does not endorse or recommend one third-party application over another. New York Medicaid is not responsible for your use of a third-party application and disclaims all liability resulting from that use.

Learn more about your rights as a patient under HIPAA and who is obligated to follow HIPAA.

Understand the FTC's policies about mobile third-party application privacy and security for consumers .