NYSOTA EI Provider and Municipality Survey Report

EI Provider Report
The following report is based on responses of 86 occupational therapists. It should be noted that all participants did not finish the entire survey or answer all questions. Approximately 74% of participants answered all survey questions. In response to the amount of time spent on billing, 84 % of providers report spending more time processing billing than they previously had. Of those reporting an increased time in billing 49% indicate that this has caused them to have decreased time to provide direct client services.

Questions regarding day to day expenses in running their businesses, 75% of providers indicate that they have seen an increase in costs. In review of the open ended data related to the causes of increase operating expenses the main categories that: office and support staff required to complete paperwork time needed to follow up with the insurance companies supplies needed such as basic office supplies for billing requirements gas needed to travel to patients training requirements for billing procedures.

The majority of providers report that they have had substantial wait times in receiving reimbursements from claims with 44% indicating unpaid claims dating back more than 120 days and 21% indicating waits of 90-120 days.

In addition, an overwhelming majority of providers (89%) reported that they do not feel competent billing 3rd party insurance companies.

The majority of providers indicated that they do not plan to withdraw as an EI provider or cancel their contracts with the DOH.

The majority of providers (74%) that responded have not given up their independent status to work for a larger agency

91% will continue to provide Early Intervention services while 9% will stop providing EI services.

45% of providers remaining in EI indicated that they or the agencies in which they work have begun limiting the number of EI cases they are accepting

Overall, 82% of providers indicated that they do not believe that the EI program is moving in the right direction. When asked to provide comment, responses indicated that providers feel they: are unable to keep up with the never-ending changes to the EI system find the billing process extraordinarily cumbersome have not received proper training regarding all of the changes spend too much time watching webinars regarding the new system have a difficult time receiving payment are frustrated with parents receiving payment and needing to obtain payment from them versus directly from EI believe the new system is not responsive to the needs of children and their families.

Municipality Report
The survey for Municipalities was completed by 13 participants (NYSOTA did not have access to many of the EIO email addresses). Results are as follows: 54% of respondents indicating no longer delay in start of services.

Despite being able to continue to provide services, 62% of Municipalities surveyed indicated they have had an uncommon loss of providers.

All Municipalities (100%) surveyed indicated that they have not received fiscal relief since the BEI assumed the responsibility for the management of EIP billing.

58% of Municipalities indicated that providers have not begun to refuse cases which have commercial insurer coverage or new EI cases.

In terms of payment and reimbursement 75% of Municipalities indicated that they have seen an increase in the time they are waiting for reimbursement for EI services from New York State since April 1st 2013.

83% indicate they are not able to easily track where escrow monies are allocated

82% have had to dedicate staff to monitor where the Municipalitys escrow monies are allocated.

Municipalities in general report that the financial tracking responsibility for the providers is overwhelming and severely impacts our independents who are our main source for service provision. Additionally they indicate that although they have not lost providers at this point if the situation continues as is with increased billing and paperwork requirements and lack of payment they anticipate that this will change.