|
||||||
|
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, 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.
************************************************************************************************************
************************************************************************************************************
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
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 Benificiary (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.
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.
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.
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
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)
ENTER
TAXONOMY CODE This
code is used for classifying health care providers according to provider type
or practitioner specialty.
SERVICE TYPE Enter
the code identifying the type of service you are providing.
ORDERING
PRV # Enter
the MMIS Provider Identification Number or Profession Code and State license
number of the ordering provider, if applicable. Press the ENTER key.
PROMPT DISPLAYED ACTION/INPUT
REFERRING
PRV # Enter
the Medicaid provider number of the referring provider. For Restricted
Clients, enter their Primary Provider’s number. Press the ENTER key.
COPAY
EXEMPT If the
service you are rendering does not require co-payment, or if the client is
exempt or has met their co-payment maximum responsibility, enter 1 for yes.
If the client is not exempt from co-payment, enter 2 for no. Note: Bypassing this prompt will enter a 2 for no.
# SERVICE
UNITS Enter
the total number of service units.
Press the
ENTER key.
Note: The following two prompts are required
for DVS transactions only and will
only appear when
Tran Type
6 is entered.
ENTER ITEM/NDC # Enter
the five-digit
·
LT (Left Side)
·
RT (Right Side)
For
DVS authorization, enter the modifier immediately following
the procedure code, with no spaces between the modifier
and code.
For
some items, if instructed by
For
Dental DVS: Enter a constant value of ‘D’; the five character Dental
procedure code; and a two-digit tooth number, a one character primary tooth,
or two character tooth quadrant/arch.
ENTER
QUANTITY Enter
the total number of units dispensed for the current date of service only.
For
Dental DVS: Enter the number of times the procedure was performed.
Note: If you are using Tran Type 7:
# LAB TESTS If
you are a lab provider, enter the number of lab tests you are performing and
press the ENTER key. Bypass by pressing the ENTER key.
# Generic/OTC Rx If you are a Pharmacy
provider, enter the number of generic prescriptions or over the counter items
you are dispensing and press the ENTER
key. Bypass by pressing the ENTER key.
# BRAND RX If
you are a Pharmacy, enter the number of brand prescriptions you are
dispensing and press the ENTER key.
Bypass by pressing the ENTER key.
# OF RX SUPPLIES Enter
the number of supplies you are dispensing and press the ENTER key. Bypass by pressing the ENTER key.
Note: If you are a POST and CLEAR Provider, enter
the appropriate data for the following two prompts.
# LAB
TESTS Enter
the number of lab tests you are ordering. Press the ENTER key.
#RX/OTC Enter
the number of prescriptions or over the counter items. Press the ENTER key.
PROMPT DISPLAYED (contd.) ACTION/INPUT
DIALING,
WAITING FOR ANSWER,
CONNECTED,
TRANSMITTING,
RECEIVING, and PROCESSING
The MEVS receipt presents
information in two sections:
·
Input, which always begins with TODAY’S DATE and
displays all information entered into the terminal.
·
Response,
which always begins with PROV NO.: and contains all fields returned by MEVS.
VERIFONE RESPONSE DESCRIPTION/COMMENTS
PROV NO.: The
eight-digit MMIS Provider Identification Number.
DATE SVC: The
date for which services were requested.
MEDICAID ID: The
Medicaid number (CIN) is displayed on the receipt if the client is
identified. If the client cannot be identified, the information entered will
be displayed.
HIC NO: Health
Insurance Claim number for Medicare.
DOB: The
client’s date of birth.
GENDER: The
client’s gender:
M = Male
F = Female
U =
Unborn
CNTY/OFF: The
two digit county code is displayed for Upstate clients, for Downstate
clients, the 3-digit NYC office code is displayed.
ANNIV DT: The
date the client’s current benefit year began.
MSG: If
applicable, the client’s Category of Assistance or exception codes will be
returned.
The
Month that the client is due for Recertification will also be displayed here.
-----------------------------------
Rej Reason Cd: This
field displays the Reject Reason codes. Please
see
the REJECT CODES section for details.
Folw-Up
Act Cd: C
= Please Correct and Resubmit
P
= Please Resubmit Original Transaction
INFO #: Call
the telephone number displayed for more information.
-----------------------------------
Rej Reason Cd: This
field displays the Reject Reason codes. Please see the REJECT CODES section
for details.
Folw-Up
Act Cd: C
= Please Correct and Resubmit
P
= Please Resubmit Original Transaction
VERIFONE RESPONSE DESCRIPTION/COMMENTS
-----------------------------------
----------------------------------- information. Medicare
and Other insurance information may be
displayed, separated by dashes (-----).
Plan: This
field displays the name of plan.
Plan Policy Number: This field
displays the policy number assigned to the other Third
Party Insurance.
Plan Cd: This
field displays the 2-character code for other Third Party Insurance, if
available. If you see an Insurance Code of ZZ, call 1-800-343-9000
to obtain additional Insurance and coverage information.
Plan Address: This
field displays the Address, City, State and Zip Code of the Managed Care Plan
or other Third Party Insurance.
Elig/Ben Info: This
field displays the client’s level of medical coverage or other coverages,
please see the ELIGIBILITY CODES section for details.
INFO #: Call
the telephone number displayed for more information.
Serv Type Cd: This
field displays one or more of the following values to further define
coverage, exclusions and limitations.
30
= Health Benefit Plan Coverage
48
= Hospital Inpatient
54
= Long Term Care
82
= Family Planning
86
= Emergency
Insr Type
Cd: C1
= Commercial
MP
= Medicare Primary
MC
= Medicaid
QM
= Qualified Medicare Beneficiary
Plan Cov Desc: This field will
display a message for UT limits exceeded,
client
restrictions, and limitations.
Time Per
Qual: 29
= Copay Remaining
30
= UT exceeded
Dollar
Amt: This
field displays the amount of copay remaining on the client’s file.
-----------------------------------
HEALTH CARE SERVICES This section
displays information relating to Service
----------------------------------- Authorization (SA) or
Dispensing Validation System (DVS)
requests.
Action
Cd: A1
= Certified in total
A3
= Not Certified
A6
= Modified
CT
= Contact Payer
NA
= No Action Required
INFO #: Call
the telephone number displayed for more
information.
Ref Id: This
field displays a message or DVS number.
Modified Units: This
field shows the partial units that were approved
for
the Service Authorization (SA) requested.
|
----------------------------------- units,
posted lab units, and posted Rx/OTC units. Dental Info: This field shows the tooth, arch and quadrant for a Dental DVS Confirmation. Quantity
Approved: This field
shows the quantity that was approved for a DVS Confirmation. Rej Reason Cd: This
field displays the Reject Reason codes. CODE ASSOCIATED COVERAGES 1 -
ACTIVE COVERAGE MA
ELIGIBLE MA
ELIGIBLE HR UTILIZATION THRESHOLD B -
COPAYMENT COPAYMENT E -
EXCLUSIONS ELIGIBLE
ONLY OUTPATIENT CARE ELIGIBLE
EXCEPT NURSING FACILITY SERVICES F - LIMITATIONS AT SERVICE LIMIT COMMUNITY COVERAGE NO LTC COMMUNITY COVERAGE W / CBLTC ELIGIBLE ONLY FAMILY PLANNING SERVICES EMERGENCY SERVICES ONLY MEDICARE COINSURANCE DEDUCTIBLE ONLY OUTPATIENT COVERAGE NO LTC OUTPATIENT COVERAGE NO NFS OUTPATIENT COVERAGE W / CBLTC PERINATAL FAMILY PRESUMPTIVE ELIGIBILITY LONG- TERM/HOSPICE PRESUMPTIVE
ELIGIBILITY PRENATAL A PRESUMPTIVE
ELIGIBILITY PRENATAL B N - SERVICES RESTRICTED TO SERVICES RESTRICTED TO THE
THE FOLLOWING PROVIDER FOLLOWING
PROVIDER R - OTHER
OR ADDITIONAL PAYOR ELIGIBLE
CAPITATION GUARANTEE FAMILY
HEALTH PLUS MC -
MANAGED CARE COORDINATOR ELIGIBLE
PCP ************************************************************************************************************ ************************************************************************************************************ REJECT
CODES CODE POSSIBLE ERRORS CT - CONTACT PAYER CALL
1-800-343-9000 I - NON COVERED NOT MA ELIGIBLE NO
COVERAGE PENDING FAMILY HEALTH PLUS U - CONTACT FOLLOWING ENTITY CALL 1-800-343-9000 FOR ELIGIBILITY OR BENEFIT INFORMATION Y - SPENDDOWN NO COVERAGE: EXCESS
INCOME 15 -
REQUIRED APPLICATION NO
UNITS ENTERED DATA MISSING |
|
REJECT CODES (contd.) CODE POSSIBLE ERRORS 33 – INPUT ERRORS ITEM NOT COVERED
MISSING/INVALID
DVS QUANTITY
CURRENT
DATE REQUIRED
COS/ITEM
INVALID
MISSING/INVALID
TOOTH/QUADRANT
41 – AUTHORIZATION/ACCESS DOWNLOAD REQUIRED
RESTRICTIONS INVALID TRAN TYPE
INVALID
TERMINAL ACCESS
SERVICE
NOT ORDERED
LOST/STOLEN
TERMINAL
PAYMENT
PAST DUE
SSN ACCESS NOT ALLOWED42 –
UNABLE TO RESPOND AT RESUBMIT
TRANSACTION CURRENT TIME
43 – INVALID/MISSING PROVIDER INVALID PROVIDER NUMBER INFORMATION REENTER
ORDERING PROVIDER INVALID
PROFESSION CODE DISQUALIFIED
ORDERER DECEASED
ORDERER INVALID
ORDERING PROVIDER INVALID
REFERRING PROVIDER NUMBER PRESCRIBING
PROVIDER LICENSE INACTIVE 45 –
INVALID/MISSING PROVIDER INVALID
TAXONOMY OR SERVICE TYPE SPECIALTY 48 – INVALID/MISSING PROVIDER REENTER ORDERING
PROVIDER
IDENTIFICATION NUMBER DISQUALIFIED ORDERER
DECEASED
ORDERER
INVALID
ORDERING PROVIDER
INVALID
REFERRING PROVIDER ID NUMBER
PRESCRIBING PROVIDER LICENSE INACTIVE49 –
PROVIDER IS NOT RESTRICTED RECIPIENT NO AUTHORIZATION PRIMARY
PHYSICIAN MCCP RESTRICTED RECIPIENT NO
AUTHORIZATION 50 –
PROVIDER INELIGIBLE FOR PROVIDER
NOT ELIGIBLE INQUIRIES 51 –
PROVIDER NOT ON FILE PROVIDER
NOT ON FILE 52 – SERVICE DATES NOT WITHIN PROVIDER INELIGIBLE SERVICE ON
DATE Provider Plan Enrollment PERFORMED 53 – INQUIRED BENEFIT INCONSISTENT PROVIDER TYPE 60 – DATE
OF BIRTH FOLLOWS SERVICE
DATE PRIOR TO BIRTHDATE DATE OF SERVICE62 – DATE
OF SERVICE NOT WITHIN INVALID
DATE ALLOWABLE INQUIRY PERIOD69 –
INCONSISTENT WITH PATIENT’S AGE EXCEEDS MAXIMUM
AGE AGE
PRECEDES MINIMUM
70 –
INCONSISTENT WITH PATIENT’S ITEM/GENDER
INVALID GENDER |
|
REJECT CODES (contd.) CODE POSSIBLE ERRORS 72 –
INVALID/MISSING INVALID CARD THIS RECIPIENT SUBSCRIBER/INSURED
ID INVALID
ACCESS NUMBER INVALID
MEDICAID NUMBER INVALID
SEQUENCE NUMBER 75 –
SUBSCRIBER/INSURED SOCIAL SECURITY NUMBER NOT ON FILE
NOT FOUND RECIPIENT NOT ON FILE
NO
COVERAGE: PENDING FHP NO
MATCH ON FILE 84 -
CERTIFICATION NOT DVS
NUMBER NOT REQUIRED REQUIRED FOR THIS SERVICE (For OMNI
3750 transactions).
PA
NOT REQ/MEDIA TYPE INVALID (All
except OMNI 3750). 87 –
EXCEEDS PLAN MAXIMUMS AT
SERVICE LIMIT EXCEEDS FREQUENCY LIMIT MAXIMUM QUANTITY EXCEEDED 88 –
NON-COVERED SERVICE PROCEDURE CODE NOT COVERED
ITEM NOT COVERED 89 – NO
PRIOR APPROVAL NO
AUTHORIZATION FOUND 91 –
DUPLICATE REQUEST DUPLICATE – UT PREVIOUSLY APPROVED
DUPLICATE DVS 95 –
PATIENT NOT ELIGIBLE NOT MEDICAID ELIGIBLE
FAMILY HEALTH PLUS NO COVERAGE: PENDING FHP NO COVERAGE: EXCESS INCOME CLIENT MEDICARE PART D DENIAL ************************************************************************************************************ ************************************************************************************************************ ERROR RESPONSES
VERIFONE RESPONSE DESCRIPTION/COMMENTS BAD
ACCESS NUMBER Medicaid
number (CIN) not valid. BAD TX
COMMUN Bad
transmission communication exists with the network. CHECK
LINE The
VeriFone terminal is not plugged in or the terminal is on the same line as a
telephone, which is off the hook or in use. CONNECT
2400 This
message is displayed until transmission to the host computer begins. DOWNLOAD
REQUIRED The
VeriFone software is obsolete and must be updated. INV PRV
SELECTED A
provider number selection was made that is not programmed into the terminal. INV TRANS
TYPE An
invalid transaction type other than 1-4, 6 or 7 was entered. INVALID DATE Illogical
date or a date which falls outside of the allowed
inquiry period of 24 months. |
|
ERROR RESPONSES
VERIFONE
RESPONSE DESCRIPTION/COMMENTS INVALID RESPONSE RECEIVED Retry transaction. INVALID TAXONOMY CODE The Taxonomy Code
entered was invalid. NO ANSWER The
VeriFone is unable to connect with the network. NO ENQ
FROM HOST No
enquiry received from host. A problem exists with the network. NO RESP
FRM HOST No
response received from host. A problem exists with the network. PLEASE TRY AGAIN The card swipe was
unsuccessful. PROCESSING The
message is displayed until the host message is ready
to be displayed. RECEIVING This
message is displayed until the host message is received by the VeriFone. TRANSMITTING This
message is displayed until the host computer acknowledges the transmission. UNREADABLE
CARD Will be
displayed after three unsuccessful attempts to swipe the card. WAITING
FOR ANSWER This
message is displayed until connection is made with the network. |