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
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