GIS 14 MA/024:Claim Transmittal, OHIP-0031

The purpose of this General Information System (GIS) message is to advise local departments of social services of changes to the Claim Transmittal form/OHIP-0031 rev 7/2014, a copy of which is attached. The Claim Transmittal is used when submitting medical bills for reimbursement to the New York State Department of Health (SDOH), Medicaid Financial Management (FMG) Group, in Albany, NY.

It has been brought to the attention of SDOH that FMG requires the National Drug Code and/or the Procedure Code, also known as the CPT Code, in order to process reimbursement requests. The National Drug Code can be found on the detailed informational sheet supplied by the pharmacy and the CPT Code can be found on the bill from the medical provider. The recipient must continue to submit these documents to the district when requesting reimbursement of medical expenses and the district must include these documents with the Claim Transmittal when sending it to FMG.

Please direct any questions to your local district liaison.