NEW YORK STATE PROGRAMS MEVS INSTRUCTIONS FOR COMPLETING A TELEPHONE TRANSACTION · Be sure to convert all alpha characters to numeric prior to dialing. · Press * (asterisk key) once to clear a mistake; or to repeat a response. · Once you are familiar with the prompts and wish to make your entries without waiting for the prompts, just continue to enter the data in the proper sequence. As in all transactions (prompted or unprompted), press the # key after each entry. · For assistance or further information on input or response messages, call the Provider Services staff at 1-800-343-9000. · For some prompts, if entry is invalid, the ARU will repeat the prompt. This allows you to correct the entry without re-keying the entire transaction. · The call is terminated if excessive errors are made. · For description or clarification of any response, see the MEVS Provider Manual. · Nonapplicable prompts may be bypassed by pressing #. · To begin the transaction, Dial 1-800-997-1111 ALPHA CONVERSION CHART A = 21 H = 42 O = 63 V = 83 B = 22 I = 43 P = 71 W = 91 C = 23 J = 51 Q = 11 X = 92 D = 31 K = 52 R = 72 Y = 93 E = 32 L = 53 S = 73 Z = 12 F = 33 M = 61 T = 81 G = 41 N = 62 U = 82 VOICE PROMPT ACTION/INPUT NEW YORK STATE MEDICAID None IF ENTERING ALPHANUMERIC (CIN) IDENTIFIER, ENTER NUMBER 1 Enter 1 or 2 IF ENTERING NUMERIC IDENTIFIER Press #. (ACCESS #) ENTER NUMBER 2 ENTER IDENTIFICATION NUMBER Enter the recipient’s converted alphanumeric Medicaid number (CIN) or numeric access number. Press #. ENTER NUMBER 1 FOR SERVICE AUTHORIZATION OR NUMBER 2 FOR Enter 1 or 2. Press #. ELIGIBILITY INQUIRY ENTER SEQUENCE NUMBER If the Identification Number entry was a Medicaid number (CIN), enter the two-digit sequence number. No entry is necessary if the numeric Access Number was entered. Press # to bypass the prompt. ENTER DATE Press # for today’s date or enter MMDDYY for verification on a previous date of service. Press #. ENTER PROVIDER NUMBER Enter Provider ID Number. Press #. ENTER SPECIALTY CODE If applicable, enter the three-digit specialty code and press #, or press # to bypass. ENTER REFERRING PROVIDER Enter the Medicaid provider number of the referring NUMBER provider. Press #. If the recipient is not a referral, press # to bypass this prompt. ENTER FIRST CO-PAYMENT TYPE Enter the converted co-payment type or press # to bypass the rest of the co-payment prompts.	VOICE PROMPT ACTION/INPUT ENTER CO-PAYMENT UNITS Enter the number of units being rendered or press # to bypass the rest of the co-payment prompts. ENTER SECOND CO-PAYMENT TYPE Enter the converted co-payment type or press # to bypass the rest of the co-payment prompts. ENTER CO-PAYMENT UNITS Enter the number of units being rendered or press # to bypass the rest of the co-payment prompts. ENTER THIRD CO-PAYMENT TYPE Enter the converted co-payment type or press # to bypass the rest of the co-payment prompts. ENTER CO-PAYMENT UNITS Enter the number of units being rendered or press # to bypass the rest of the co-payment prompts. ENTER FOURTH CO-PAYMENT TYPE Enter the converted co-payment type or press # to bypass the rest of the co-payment prompts. ENTER CO-PAYMENT UNITS Enter the number of units being rendered or press # to bypass the rest of the co-payment prompts. ENTER NUMBER OF SERVICE UNITS Enter the total number of service units rendered. Press #. IF YOU ARE A DESIGNATED POSTING If you are a designated Posting Provider, Enter the total PROVIDER, ENTER NUMBER OF LAB number of Lab tests being ordered and TESTS YOU ARE ORDERING Press # or Press # to bypass. IF YOU ARE A DESIGNATED POSTING If you are a designated Posting Provider, Enter the total PROVIDER, ENTER NUMBER OF number of prescriptions or over the counter items being PRESCRIPTIONS OR OVER THE ordered and Press #, or Press # to bypass. COUNTER ITEMS YOU ARE ORDERING ENTER ORDERING PROVIDER Enter the MMIS provider ID number or License Type NUMBER and License Number of the ordering provider, if applicable. Press #. ****************************************************************************************************************** ****************************************************************************************************************** RESPONSES TELEPHONE RESPONSE DESCRIPTION/COMMENTS MEDICAID NUMBER AA22346D The response begins with the recipient’s eight-digit Medicaid CIN. COUNTY CODE 24 Recipient’s two-digit county code. ELIGIBLE CAPITATION GUARANTEE Indicates guaranteed status under a Prepaid Capitation Program (PCP). ELIGIBLE EXCEPT LONG TERM CARE Recipient is eligible to receive all Medicaid services except for Long Term Care. ELIGIBLE ONLY FAMILY PLANNING Recipient is eligible for Medicaid covered family SERVICES planning services. ELIGIBLE ONLY OUTPATIENT CARE Recipient is eligible for all ambulatory care, including prosthetics, no inpatient coverage.
RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS ELIGIBLE PCP Recipient covered by a Prepaid Capitation Program (PCP) as well as eligible for limited fee-for-service benefits. EMERGENCY SERVICES ONLY Recipient is eligible for emergency services only. FAMILY HEALTH PLUS Recipient is enrolled in the Family Health Plus Program (FHP). MEDICAID ELIGIBLE HR UTILIZATION Recipient is eligible to receive all Medicaid services THRESHOLD with prescribed limits. A service authorization must be obtained for services limited under Utilization Threshold. MEDICAID ELIGIBLE Recipient is eligible for all benefits. MEDICARE COINSURANCE AND Recipient is eligible for payment of Medicare DEDUCTIBLE ONLY coinsurance and deductibles only. PERINATAL FAMILY Recipient is eligible to receive a limited package of benefits. See MEVS Manual for excluded services. PRESUMPTIVE ELIGIBLE LONG- Recipient is eligible for all Medicaid services except TERM/HOSPICE hospital based clinic services, hospital emergency room services, hospital inpatient services, and bed reservation. PRESUMPTIVE ELIGIBILITY Recipient is eligible to receive all Medicaid services PRENATAL A except inpatient care, institutional long-term care, alternate level care, and long-term home health care. PRESUMPTIVE ELIGIBILITY Recipient is eligible to receive only ambulatory PRENATAL B prenatal care services. See MEVS Manual for excluded services. ANNIVERSARY MONTH OCTOBER This is the beginning month of the recipient’s benefit year. CATEGORY OF ASSISTANCE S Recipient is enrolled in the SSI assistance program. MEDICARE PART A Recipient has only Part A Medicare. MEDICARE PART B Recipient has only Part B Medicare. MEDICARE PARTS A and B Recipient has both Parts A and B. MEDICARE PARTS A & B & QMB Recipient has Part A and B Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PART A & QMB Recipient has Part A Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PART B & QMB Recipient has Part B Medicare coverage and is a Qualified Medicare Beneficiary (QMB).	RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS MEDICARE QMB ONLY Recipient is a Qualified Medicare Beneficiary (QMB) Only. HEALTH INSURANCE CLAIM NUMBER Health Insurance Claim number. XXXXXXXXXXXX HEALTH INSURANCE CLAIM NUMBER Health Insurance Claim number is not on file. NOT ON FILE INSURANCE COVERAGE CODE 21: Insurance and Coverage Codes equal the Insurance DENTAL, PHYSICIAN, INPATIENT carrier and the scope of benefits. EXCEPTION CODE 35 Recipient’s exception and/or restriction code. NO CO-PAYMENT REQUIRED Recipient is under 21 or exempt from co-payment and co-payment data has been entered. CO-PAYMENT REQUIREMENTS MET Recipient has reached his/her co-payment maximum. ON MM/DD/YY AT SERVICE LIMIT The recipient has reached his/her limit for that particular service category. No service authorization is created. DUPLICATE – UT PREVIOUSLY Request is a duplicate of a previously approved service APPROVED authorization. PARTIAL APPROVAL XX SERVICE Indicates that the full complement of requested services UNIT(S), XX LAB UNIT(S), XX relative to Post and Clear processing is not available. PHARMACY UNIT(S) POST AND The XX represents the number of services CLEAR approved/available. PARTIAL APPROVAL XX SERVICE Indicates that the full complement of requested services UNIT(S), XX LAB UNIT(S), XX relative to Utilization Threshold processing is not PHARMACY UNIT(S) UTILIZATION available. The XX represents the number of services THRESHOLD approved/available. SERVICE APPROVED NEAR LIMIT The service authorization has been granted and XX SERVICE UNIT(S), XX LAB UNIT(S), recorded. The recipient has almost reached his/her XX PHARMACY UNIT(S) service limit for that particular category. SERVICE APPROVED UTILIZATION The service units requested are approved. THRESHOLD XX SERVICE UNIT(S), XX LAB UNIT(S), XX PHARMACY UNIT(S) SERVICES APPROVED POST AND The ordering provider has posted services and the CLEAR XX SERVICE UNIT(S), XX LAB units have been approved. UNIT(S), XX PHARMACY UNIT(S) FOR DATE MMDDYY The date for which services were requested will be heard when message is complete. Press # to repeat entire message.
ERROR RESPONSES TELEPHONE RESPONSE DESCRIPTION/COMMENTS CALL 800-343-9000 When certain conditions are met (ex: multiple responses), you need to call the Provider Services staff for additional data. DECEASED ORDERING PROVIDER The Ordering Provider is deceased. DISQUALIFIED ORDERING The Ordering Provider is identified as excluded/ PROVIDER disqualified and cannot prescribe. EXCESSIVE ERRORS, REFER TO Too many invalid entries. Refer to the input data MEVS MANUAL OR CALL 800-343- section or call 1-800-343-9000. 9000 FOR ASSISTANCE INVALID ACCESS METHOD The received transaction is classified as a Provider Type/Transaction Type Combination that is not allowed to be submitted through the telephone. INVALID ACCESS NUMBER Incorrect access number. INVALID CARD THIS RECIPIENT Recipient has used an invalid card.