NEW YORK STATE PROGRAMS

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.

·          Important Note: The New York State Department of Health (NYSDOH) implemented the NPI system changes on September 1, 2008.  Temporarily,  NYS Medicaid Provider ID’s and license numbers will continue to be accepted for processing in addition to the NPI.  NYSDOH will notify the Provider community when we will no longer accept Proprietary Identifiers from Providers that require an NPI (excludes atypical providers).

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 shortcut code associated with your Provider Identification Number.  You may also enter your ten-digit NPI or enter an eight-digit MMIS Provider ID (for atypical providers ONLY) 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 ten-digit National Provider Identifier (NPI) of the ordering provider, if applicable. Press the ENTER key.

For all atypical providers, enter the eight-digit MMIS Provider Identification Number or Profession Code and State license number of the ordering provider, if applicable. Press the ENTER key.

REFERRING PRV #

Enter the ten-digit National Provider Identifier (NPI) or the eight-digit MMIS provider ID 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.  The following modifiers may be used to further describe certain procedure codes for orthotic and prosthetic devices, and prescription footwear:

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

 

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.

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.

DIALING, WAITING FOR ANSWER, CONNECTED, TRANSMITTING, RECEIVING, and PROCESSING

The VeriFone will now dial into the MEVS system and display these processing messages:

 

RESPONSES

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 National Provider Identifier (NPI).

For all atypical providers, 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 (COA) and/or exception codes will be returned.

‘COA = S’ (The code S signifies that the client is enrolled in the SSI assistance program.)

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

VERIFONE RESPONSE

DESCRIPTION/COMMENTS

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.

 

SERVICE 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.

VERIFONE RESPONSE

DESCRIPTION/COMMENTS

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.

 

PLAN ELIG. & BENEFITS

This section displays the client’s eligibility and benefit information. Medicare and Other insurance information may be displayed, separated by dashes (-----).

VERIFONE RESPONSE

DESCRIPTION/COMMENTS

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.

VERIFONE RESPONSE

DESCRIPTION/COMMENTS

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.

 

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 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 THE FOLLOWING PROVIDER

SERVICES RESTRICTED TO THE FOLLOWING PROVIDER

R - OTHER OR ADDITIONAL PAYOR

ELIGIBLE CAPITATION GUARANTEE FAMILY HEALTH PLUS

MC - MANAGED CARE COORDINATOR

ELIGIBLE PCP

 

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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 FOR ELIGIBILITY OR BENEFIT INFORMATION

CALL 1-800-343-9000

Y - SPENDDOWN

NO COVERAGE: EXCESS INCOME

15 - REQUIRED APPLICATION DATA MISSING

NO UNITS ENTERED

33 - INPUT ERRORS

ITEM NOT COVERED
MISSING/INVALID DVS QUANTITY
CURRENT DATE REQUIRED
COS/ITEM INVALID
MISSING/INVALID TOOTH/QUADRANT

41 – AUTHORIZATION/ACCESS RESTRICTIONS

DOWNLOAD REQUIRED
INVALID TRAN TYPE
INVALID TERMINAL ACCESS
SERVICE NOT ORDERED
LOST/STOLEN TERMINAL
PAYMENT PAST DUE
SSN ACCESS NOT ALLOWED

42 – UNABLE TO RESPOND AT CURRENT TIME

RESUBMIT TRANSACTION

43 – INVALID/MISSING PROVIDER INFORMATION

INVALID PROVIDER NUMBER
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 SPECIALTY

INVALID TAXONOMY OR SERVICE TYPE

48 – INVALID/MISSING PROVIDER IDENTIFICATION NUMBER

REENTER ORDERING PROVIDER
DISQUALIFIED ORDERER
DECEASED ORDERER
INVALID ORDERING PROVIDER
INVALID REFERRING PROVIDER ID NUMBER
PRESCRIBING PROVIDER LICENSE INACTIVE

49 – PROVIDER IS NOT PRIMARY PHYSICIAN

RESTRICTED RECIPIENT NO AUTHORIZATION MCCP RESTRICTED RECIPIENT NO AUTHORIZATION

50 – PROVIDER INELIGIBLE FOR INQUIRIES

PROVIDER NOT ELIGIBLE

51 – PROVIDER NOT ON FILE

PROVIDER NOT ON FILE

52 – SERVICE DATES NOT WITHIN Provider Plan Enrollment

PROVIDER INELIGIBLE SERVICE ON DATE PERFORMED

53 – INQUIRED BENEFIT INCONSISTENT PROVIDER TYPE

 

COS NOT VALID FOR ITEM/NDC CODE

60 – DATE OF BIRTH FOLLOWS DATE OF SERVICE

SERVICE DATE PRIOR TO BIRTHDATE

62 – DATE OF SERVICE NOT WITHIN ALLOWABLE INQUIRY PERIOD

INVALID DATE

69 – INCONSISTENT WITH PATIENT’S AGE

AGE EXCEEDS MAXIMUM
AGE PRECEDES MINIMUM

70 – INCONSISTENT WITH PATIENT’S GENDER

ITEM/GENDER INVALID

72 – INVALID/MISSING SUBSCRIBER/INSURED ID

INVALID CARD THIS RECIPIENT
INVALID ACCESS NUMBER
INVALID MEDICAID NUMBER
INVALID SEQUENCE NUMBER

75 – SUBSCRIBER/INSURED NOT FOUND

SOCIAL SECURITY NUMBER NOT ON FILE
RECIPIENT NOT ON FILE
NO COVERAGE: PENDING FHP
NO MATCH ON FILE

76 – DUPLICATE SUBSCRIBER/INSURED ID NUMBER

CALL LOCAL DISTRICT

84 - CERTIFICATION NOT REQUIRED FOR THIS SERVICE

DVS NUMBER NOT REQUIRED (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

CLIENT IS ELIGIBLE FOR EMERGENCY SERVICES ONLY

CLIENT IS MEDICARE ELIGIBLE

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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.

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.