It is harder than the letter suggests
By Elena Pak, Credentialing Department, WCH
If you are enrolled in the New York State Medicaid program, a change is coming to your practice, and for many providers it has already arrived. New York Medicaid has launched a new Provider Services Portal (PSP) and started a statewide revalidation initiative that applies to every enrolled provider. The old paper-based process for enrollment and revalidation has been discontinued. Everything now happens online, through the PSP.
The state is rolling revalidation out in phases that will continue through June 2028, so providers are being notified on a staggered schedule. Official notices go out by email and by U.S. mail. Once yours arrives, the time you have is limited: New York Medicaid currently allows 123 calendar days from the date of the initial notification to complete revalidation. That may sound like a lot, but for a practice that has to collect documents, verify information and work through a new system for the first time, it goes faster than most people expect.
What Revalidation Actually Is
Revalidation is mandatory. It is the state’s way of confirming that the information on file for each provider is still accurate and compliant, including credentials, practice locations, ownership information, NPI, and other required data. Depending on a provider’s risk classification, additional screening may also apply. Under the current framework, high-risk providers revalidate every three years, moderate-risk providers every four years, and limited-risk providers every five years.
Why You Should Not Leave It for Later
Failure to complete the revalidation process may result in termination of a provider’s Medicaid enrollment. For providers participating in Medicaid managed care, this can have broader implications, potentially affecting their participation with Medicaid managed care plans and creating interruptions in billing, reimbursement, and ongoing patient services. For a practice with a large Medicaid population, that is a serious risk to both revenue and patients, and it is one that is entirely avoidable if the process is handled on time.
The Letters Are Clear. The Portal Is Not.
The notices themselves explain that action is required, but many providers and practice administrators tell us the PSP is difficult to work through. People run into questions about account access, about provider and group information, about which documents have to be submitted, about how to handle ownership and practice details, and about what to do with the enrollment information that already exists. Once an application is submitted, there are follow-up requests to answer and a status to keep an eye on until the revalidation is finished. For organizations that manage several providers, locations or enrollments, every one of these steps multiplies.
We know this because we have been through this revalidation with our own clients. It is a difficult process, and it is easy to get something wrong or to lose weeks waiting on a problem that could have been fixed on day one. That experience is the main reason we are writing this article: if you are looking at a revalidation notice and feeling unsure, you are not alone, and you do not have to work it out by yourself.
Check Your Contact Information Before the Letter Arrives
There is another risk that gets far less attention. Medicaid sends its official notices to the correspondence address and email address in your provider file. If you have moved offices, joined a different practice, changed administrative staff or switched email addresses since you first enrolled or last revalidated, your notice may be sitting in an old inbox or going to an old mailing address. You would not know the 123 days had begun.
New York State Medicaid specifically tells providers to make sure their correspondence and email information is current. The sensible approach is not to wait for a letter and then react. Review your enrollment record now, confirm that Medicaid can reach you, and keep that information up to date as a regular part of maintaining your enrollment.
How WCH Service Bureau Can Help
WCH Service Bureau has more than 25 years of experience in credentialing and provider enrollment, and we are helping providers through the New York Medicaid PSP transition right now. We work with physician practices, behavioral health organizations, clinics, group practices and other healthcare organizations. Our team can guide you through the PSP and support your application, review and prepare the enrollment information and documentation you need, and update provider and practice demographics. We handle the revalidation submission and the follow-up afterward, track the status of your application, and respond to requests for additional information until the process is complete. We can also help with ongoing enrollment maintenance and other provider enrollment issues that come up along the way.
If you have received a New York Medicaid revalidation letter, if the PSP is giving you trouble, or if you are not sure Medicaid has your current contact information, reach out to us, and we will help you get it done correctly and on time.
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