New York State Medicaid

MEVS VeriFone Omni 3750/Vx570 Quick Reference Guide

 

Eligibility verification can only be performed on the date of service or post date of service.

 

For all Transaction Types:

·         If using the member’s Access Number (13 digit number found on member’s ID card), swipe card through the reader or key in the Access Number and press ENTER.

·         If using Medicaid number (CIN) (8 digit alpha/numeric identifier), enter using the ‘ALPHA’ key and press ENTER.

·         Enter Tran Type (see below) and press ENTER.

·         If your identification number entry was a Medicaid ID number (CIN), enter the two-digit card sequence number and press the enter key. The sequence number is the last two-digits of the access number.

o   If the Access Number was entered, this prompt will not display.

·         Press the ENTER key for today's date. If doing a transaction for a previous date of service, enter the eight-digit date, ‘MMDDCCYY’, and press the ENTER key.

·         Enter the appropriate shortcut code associated with your provider identification number (see the ‘MEVS VeriFone Omni 3750/Vx570 Quick Setup Guide’ document for adding shortcut codes.) You may also enter a ten-digit NPI or an eight-digit MMIS Provider ID (for atypical providers ONLY) and press the ENTER key.

·         For a current list of all taxonomy codes and service type codes refer to:
http://www.wpc-edi.com/content/view/711/401/

 

For:

Tran Type 1 - Service Authorization and Eligibility Inquiry (NOT for Laboratories and Pharmacies, refer to Tran Type 7) (see A, B, C, D, E, F, G)

Tran Type 2 - Eligibility Inquiry only (see A, and either B or C)

Tran Type 3 - Authorization Confirmation (see A, E, F, G)

Tran Type 4 - Authorization Cancellation (see A, E, G)

Tran Type 6 - Dispensing Validation System (DVS) Request (see A, B, C, D, H, I)

Tran Type 7 - Service Authorization & Eligibility Inquiry (see A, B, C, D, F, J, K, L)

o   Labs stop at F / Pharmacies J, K, L are required

 

A.    First see section ‘For all Transaction Types’.

B.     Ordering provider number – for providers who fill written orders/scripts

o   Enter the ten-digit National Provider Identifier (NPI) and press the ENTER key.

o   For atypical providers enter the eight-digit MMIS Provider ID number of the ordering provider and press the ENTER key.  

C.     Referring provider number – entered if client is in Restricted Recipient Program or Managed Care Coordinator Program and transaction is not done by primary provider.

o   Enter the ten-digit National Provider Identifier (NPI) or the eight-digit MMIS provider ID of the primary provider and press the enter key.

o   If the client is not restricted or in MCCP, press the ENTER key to bypass this prompt.

D.    If the client is exempt from co-payment enter 1 for yes, or 2 for not exempt.

E.     Enter the number of service units and press the ENTER key.

F.      Enter the number of lab tests you are ordering and press the ENTER key.

G.    Enter the number of prescriptions, over the counter items, DME Supply Items, including refills you are ordering and press the ENTER key.

H.    Enter the five-character HCPCS alpha/numeric item code of the item being dispensed.

o   The following modifiers may be used LT (Left Side) RT (Right Side)

o   For DVS authorization, enter the modifier immediately following the procedure code, with no spaces between the modifier and code.

o   For DME, prescription footwear and orthotic/prosthetic devices, DVS will be created for an authorization period of 180 days.

o   Note: Date-of-Service entered on the DVS request will be used to begin the authorization period. The actual date of service, which is entered on the claim, can be anytime within the 180 day authorization period.

o   For some items, if instructed by New York State, the eleven-digit National Drug Code (NDC) may be entered.

o   For Dental DVS: Enter a constant value of D; the five character Dental procedure code and a two- digit tooth number, or one character primary tooth or two-character tooth quadrant/arch.

I.       Enter the number of units dispensed for current date of service. Do not include refills.

J.       Enter number of generic prescriptions or OTC items and press the ENTER key.

K.    Enter the number of brand name prescriptions you are dispensing and press the ENTER key.

L.     Enter the number of supplies you are dispensing and press the ENTER key.

 

For Further Information Go To: http://www.emedny.org/ProviderManuals/AllProviders/supplemental.html#MEVSPM

 

If you have questions call: 1-800-343-9000