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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 #.
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.
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.
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,
NURSING FACILITY SERVICES including
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.
HEALTH INSURANCE CLAIM NUMBER Health Insurance Claim number.
XXXXXXXXXXXX
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.
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TELEPHONE RESPONSE DESCRIPTION/COMMENTS
MEDICAID
NUMBER AA22346D The
response begins with the client’s eight-digit Medicaid CIN.
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.
TELEPHONE RESPONSE DESCRIPTION/COMMENTS
HEALTH INSURANCE CLAIM NUMBER Health Insurance Claim number is 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.
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.
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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.
ERROR RESPONSES (contd.)
TELEPHONE RESPONSE DESCRIPTION/COMMENTS
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.
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.
ERROR RESPONSES (contd.)
TELEPHONE RESPONSE DESCRIPTION/COMMENTS
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
PROVIDER NOT ELIGIBLE The verification
was attempted by an inactivated or disqualified provider.
PROVIDER
RECIPIENT
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
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
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.
If
you are using the Client’s Medicaid number (CIN), enter the Medicaid number
and press the ENTER key.
ENTER
TRAN TYPE One
of the following must be entered:
1 Service Authorization and Eligibility
inquiry.
2 Eligibility inquiry only.
3 Authorization Confirmation.
4 Authorization Cancellation.
6 Dispensing Validation System
(DVS) Request.
7 Service Authorization and
Eligibility inquiry
(Lab
& Pharmacies)
Press
the ENTER key.
Note: Depending on which Tran Type you select, the
following prompts may not appear in the order in which they are listed.
ENTER SEQ # If
you are using the Medicaid Number (CIN), enter the two-digit sequence number
and press the ENTER key. Note:
This prompt will not appear if the Access number was entered as it contains
the sequence number.
ENTER
DATE Press
ENTER for today’s date or enter
MMDDCCYY for verification on a previous date of service. Press the ENTER key.
SELECT PROVIDER If you
see this prompt there are multiple provider numbers programmed into this
terminal. Enter the appropriate number associated with your Provider
Identification Number or enter an eight-digit MMIS Provider Identification
Number and press the ENTER key (To
add numbers call 1-800-343-9000)