NEW YORK STATE PROGRAMSMEVS 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 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 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 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 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. |
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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 License
Type 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. ELIGIBLE CAPITATION GUARANTEE Indicates guaranteed
status under a Prepaid Capitation Program (PCP). ELIGIBLE
EXCEPT LONG TERM CARE Client
is eligible to receive all Medicaid services except for Long Term Care. 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 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. MEDICAID ELIGIBLE Client is eligible for all
benefits. MEDICARE
COINSURANCE AND Client
is eligible for payment of Medicare DEDUCTIBLE ONLY coinsurance and deductibles
only. RESPONSES (contd.)TELEPHONE
RESPONSE DESCRIPTION/COMMENTS 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)
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 ASSISTANCEINVALID 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 covert to an alpha character. To proceed, re-enter
the data in the correct format. |
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ERROR RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS 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 LICENSE TYPE License
type 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
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 SERVICE
ON DATE PERFORMED identification 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. |
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ERROR RESPONSES (contd.) TELEPHONE RESPONSE DESCRIPTION/COMMENTS 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 |
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NEW YORK STATE PROGRAMSMEVS 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 license type and State license
number of the ordering provider, if applicable. Press the ENTER key. |
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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 New York State alpha/numeric item code of the item being
dispensed. For some items, if instructed by New York State, the
Eleven-digit National Drug Code may be entered. 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. Press the ENTER key.
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. Press the ENTER key.
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. THIS ENDS THE INPUT DATA
SECTION. The VeriFone
will now dial into the MEVS system and display these processing messages: DIALING,
WAITING FOR ANSWER, CONNECTED,
TRANSMITTING, RECEIVING,
and PROCESSING |
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RESPONSESThe 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. ----------------------------------- ELIG REQUEST REJECT This section is displayed when the eligibility
request
----------------------------------- cannot be validated
Rej Reason Cd: This
field displays the Reject Reason codes. Folw-Up
Act Cd: C
= Please Correct and Resubmit P
= Please Resubmit Original Transaction INFO #: Call
the telephone number displayed for more information. ----------------------------------- SERV REQUEST REJECT This section is
displayed when a Service
----------------------------------- Authorization(SA) or Dispensing Validation System
(DVS) request cannot be
processed or the client
is ineligible.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. |
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RESPONSES (contd.)
VERIFONE RESPONSE DESCRIPTION/COMMENTS ----------------------------------- PLAN ELIG. &
BENEFITS This section displays
the client’s eligibility and benefit
----------------------------------- information. Medicare
and Other insurance information may
be displayed, separated by dashes (-----). Plan: This
field displays the name of plan. 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. 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: This
field shows the service type code entered in the transaction. 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: N/X/X For
confirmations, this field shows the approved 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. |
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ELIGIBILITY
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 LONG-TERM CARE F - LIMITATIONS EMERGENCY SERVICES ONLY PRESUMPTIVE ELIGIBILITY LONG- TERM/HOSPICE PRESUMPTIVE
ELIGIBILITY PRENATAL A PRESUMPTIVE
ELIGIBILITY PRENATAL B PERINATAL
FAMILY ELIGIBLE
ONLY FAMILY PLANNING SERVICES AT
SERVICE LIMIT MEDICARE
COINSURANCE DEDUCTIBLE ONLY 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 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 ALLOWED
42 –
UNABLE TO RESPOND AT RESUBMIT
TRANSACTION CURRENT
TIME |
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REJECT CODES (contd.) CODE POSSIBLE ERRORS 43 – INVALID/MISSING PROVIDER INVALID
PROVIDER NUMBER INFORMATION REENTER
ORDERING PROVIDER INVALID
LICENSE TYPE 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 COS NOT VALID FOR ITEM/NDC CODE 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
PRECEEDS MINIMUM
70 –
INCONSISTENT WITH PATIENT’S ITEM/GENDER
INVALID GENDER 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).
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REJECT CODES (contd.) CODE POSSIBLE ERRORS 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 ************************************************************************************************************ ************************************************************************************************************ 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. 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. |
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ERROR RESPONSES
VERIFONE RESPONSE DESCRIPTION/COMMENTS 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. |
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