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 be transferred directly to an eMedNY Provider Services Representative, press “0” on the telephone keypad at any time during the first four prompts. The following message will be heard: “The ARU Zero Out Option”. You will then be transferred to the eMedNY Provider Services Helpdesk. · 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 client’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 Identification 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 NUMBER referring provider. Press #. If the client 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. 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. RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS MEDICAID ELIGIBLE HR UTILIZATION Client is eligible to receive all Medicaid services THRESHOLD with prescribed limits. A service authorization must be obtained for services limited under Utilization Threshold. MEDICARE COINSURANCE AND Client is eligible for payment of Medicare DEDUCTIBLE ONLY coinsurance and deductibles only. OUTPATIENT COVERAGE WITH Client is eligible for most ambulatory care, COMMUNITY BASED LONG TERM CARE including prosthetics, and short-term rehabilitation with limitations. See MEVS Provider Manual for limited and excluded services. OUTPATIENT COVERAGE WITHOUT Client is eligible for some ambulatory care, LONG TERM CARE prosthetics, and short-term rehabilitation services. See MEVS Provider Manual for excluded services. OUTPATIENT COVERAGE WITH NO Client is eligible for all ambulatory care, including NURSING FACILITY SERVICES prosthetics. See MEVS Provider Manual for excluded services. PERINATAL FAMILY Client is eligible to receive a limited package of benefits. See MEVS Provider Manual for excluded services. PRESUMPTIVE ELIGIBLE LONG- Client 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 Client 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 Client is eligible to receive only ambulatory PRENATAL B prenatal care services. See MEVS Provider Manual for excluded services. ANNIVERSARY MONTH OCTOBER This is the beginning month of the client’s benefit year. CATEGORY OF ASSISTANCE S Client is enrolled in the SSI assistance program. MEDICARE PART A Client has only Part A Medicare. MEDICARE PART B Client has only Part B Medicare. MEDICARE PARTS A and B Client has both Parts A and B. MEDICARE PARTS A & B & QMB Client has Part A and B Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PART A & QMB Client has Part A Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PART B & QMB Client has Part B Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE QMB ONLY Client is a Qualified Medicare Beneficiary (QMB) Only. MEDICARE PART D Client has only Part D Medicare Coverage.		VOICE PROMPT ACTION/INPUT 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 PROVIDER, ENTER NUMBER OF LAB the total 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 PROVIDER, ENTER NUMBER OF the total number of prescriptions or over the PRESCRIPTIONS OR OVER THE counter items being ordered and Press #, COUNTER ITEMS YOU ARE ORDERING or Press # to bypass. ENTER ORDERING PROVIDER Enter the MMIS Provider Identification Number or NUMBER Profession Code and License Number of the ordering provider, if applicable. Press # or Press # to bypass. ************************************************************************************************************ ************************************************************************************************************ RESPONSES TELEPHONE RESPONSE DESCRIPTION/COMMENTS MEDICAID NUMBER AA22346D The response begins with the client’s eight-digit Medicaid CIN. COUNTY CODE XX Client’s two-digit county code. COMMUNITY COVERAGE WITH Client is eligible to receive most Medicaid services. See COMMUNITY BASED LONG TERM CARE MEVS Provider Manual for excluded services. COMMUNITY COVERAGE WITHOUT Client is eligible for acute inpatient care, care in a LONG TERM CARE psychiatric center, some ambulatory care, prosthetics, and short-term rehabilitation services. See MEVS Provider Manual for excluded services. ELIGIBLE CAPITATION GUARANTEE Indicates guaranteed status under a Prepaid Capitation Program (PCP). ELIGIBLE EXCEPT NURSING FACILITY Client is eligible to receive all Medicaid services except SERVICES nursing facility services provided in a SNF or inpatient setting. See MEVS Provider Manual for limited and excluded services. ELIGIBLE ONLY FAMILY PLANNING Client is eligible for Medicaid covered family SERVICES planning services. ELIGIBLE ONLY OUTPATIENT CARE Client is eligible for all ambulatory care, including prosthetics, no inpatient coverage. ELIGIBLE PCP Client covered by a Prepaid Capitation Program (PCP) as well as eligible for limited fee-for-service benefits. EMERGENCY SERVICES ONLY Client is eligible for emergency services only. FAMILY HEALTH PLUS Client is enrolled in the Family Health Plus Program (FHP). MEDICAID ELIGIBLE Client is eligible for all benefits. RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS MEDICARE PARTS A & D Client has both Part A and Part D Medicare Coverage. MEDICARE PARTS B & D Client has both Part B and Part D Medicare Coverage. MEDICARE PARTS A & B & D Client has Part A and Part B and Part D Medicare Coverage. MEDICARE PARTS A & B & D Client has Part A and Part B and Part D Medicare & QMB coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PARTS A & D & QMB Client has Part A and Part D Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PARTS B & D & QMB Client has Part B and Part D Medicare coverage and is a Qualified Medicare Beneficiary (QMB). MEDICARE PART D & QMB Client has Part D Medicare coverage and is a Qualified Medicare Beneficiary (QMB). 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 DENTAL, PHYSICIAN, INPATIENT Insurance carrier and the scope of benefits. EXCEPTION CODE 35 Client’s exception and/or restriction code. NO CO-PAYMENT REQUIRED Client is under 21 or exempt from co-payment and co-payment data has been entered. CO-PAYMENT REQUIREMENTS MET Client has reached his/her co-payment maximum. ON MM/DD/YY AT SERVICE LIMIT The client 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 APPROVED service authorization. PARTIAL APPROVAL XX SERVICE Indicates that the full complement of requested UNIT(S), XX LAB UNIT(S), XX services relative to Post and Clear processing is PHARMACY UNIT(S) POST AND not available. The XX represents the number of CLEAR services approved/available. PARTIAL APPROVAL XX SERVICE Indicates that the full complement of requested UNIT(S), XX LAB UNIT(S), XX services relative to Utilization Threshold PHARMACY UNIT(S) UTILIZATION processing is not available. The XX represents THRESHOLD the number of services approved/available. SERVICE APPROVED NEAR LIMIT The service authorization has been granted and XX SERVICE UNIT(S), XX LAB UNIT(S), recorded. The client 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)
	RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS 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 Client has used an invalid card. INVALID CO-PAYMENT Invalid number of digits or number doesn't convert to an alpha character. To proceed, re-enter the data in the correct format. INVALID CO-PAYMENT, REFER TO The Data entered is not a valid Co-payment value. MEVS MANUAL INVALID DATE Illogical date or a date which falls outside of the allowed inquiry period of 24 months. INVALID ENTRY An invalid number of digits was entered for service units. INVALID IDENTIFICATION NUMBER The client identification number not valid. INVALID PROFESSION CODE Profession Code not valid. INVALID MEDICAID NUMBER Medicaid number (CIN) not valid. INVALID MENU OPTION An invalid entry was made when selecting the identifier type. INVALID ORDERING PROVIDER Ordering Provider Identification Number or license NUMBER number entered NUMBER was not found on the file. INVALID PROVIDER NUMBER Provider Identification Number invalid. INVALID REFERRING PROVIDER Referring Provider Identification Number invalid. NUMBER		ERROR RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS INVALID SEQUENCE NUMBER The sequence number entered is not valid or not current. INVALID SPECIALTY CODE The specialty code was either entered incorrectly, or not associated with the provider’s category of service, or the provider is a clinic and a required specialty was not entered. MCCP RECIPIENT NO Client is restricted. Services must be provided, AUTHORIZATION ordered, or referred by the primary provider. NO COVERAGE EXCESS INCOME Client has an income in excess of the allowable levels and must spenddown the excess in order to be eligible. NO COVERAGE PENDING FAMILY Client is waiting to be enrolled into a Family Health HEALTH PLUS Plus Managed Care Plan. NO SERVICE UNITS ENTERED No entry was made and the units are required for this transaction. NOT MEDICAID ELIGIBLE Client is not eligible for benefits on the date of service entered. PRESCRIBING PROVIDER License number is not active for the date of service LICENSE NOT IN ACTIVE STATUS entered. PROVIDER INELIGIBLE FOR The category of service for the Provider identification SERVICE ON DATE PERFORMED number submitted in the transaction is inactive or invalid for the date of service entered. PROVIDER NOT ELIGIBLE The verification was attempted by an inactivated or disqualified provider. PROVIDER NOT ON FILE The Provider Identification Number entered is not identified as a Medicaid enrolled provider. RECIPIENT NOT ON FILE Client identification number (CIN) is not on file. The number is either incorrect or the client is no longer eligible and the number is no longer on file. REENTER ORDERING PROVIDER Ordering provider number or license number has an NUMBER incorrect format (wrong length or characters in the wrong position). RESTRICTED RECIPIENT NO Enter the MMIS Provider Identification Number to AUTHORIZATION whom the client is restricted. SERVICES NOT ORDERED The ordering provider did not post the services you are trying to clear. SSN ACCESS NOT ALLOWED The provider is not authorized to access the system using a social security number. SSN NOT ON FILE The entered nine-digit number is not on the Client Master file. SYSTEM ERROR # A network problem exists. Call 1-800-343-9000 with the error number. THE SYSTEM IS CURRENTLY System is unavailable. After hearing this message UNAVAILABLE. PLEASE CALL you will be disconnected. 800-343-9000 FOR ASSISTANCE
	NEW YORK STATE PROGRAMS MEVS INSTRUCTIONS USING VERIFONE Omni 3750 · ENTER key must be pressed after each field entry. · For assistance or further information on input or response messages, call Provider Services staff, 1-800-343-9000. · To add provider numbers to your terminal, call 1-800-343-9000. (Please maintain a listing of provider numbers and associated values.) · To enter a number, press the key with the desired number. · To enter a letter, press the key with the desired letter, and then press the alpha key until the letter appears in the display window. PROMPT DISPLAYED ACTION/INPUT To begin, press the RED key, press the F4 key to start the verification. ENTER CARD OR ID If you are using the client’s access number then swipe the card through reader, or key the access number then press the ENTER key.