checking eligibility through Medicare IVR

DME MAC A IVR User Guide - Eligibility Options

Eligibility - Option 2

When the eligibility option is selected, the IVR will request the following elements:

• National Provider Identifier (NPI)
• PTAN (10-digit supplier number)
• Last 5 digits of the Tax Identification Number (TIN)
• Beneficiary Medicare number
• Beneficiary first and last name (last name and first initial if using touch-tone)
• Beneficiary date of birth
• Date of service

Once the authentication elements have been verified, the IVR will supply the following, if applicable:

• Part A and Part B effective/termination dates
• Current/prior year Part B deductible amounts
• Medicare Secondary Payer (MSP) type, insurer name, and effective/termination dates
• Medicare Advantage Plan number, name, address, telephone number and effective/termination dates
• Home health name, address, and effective/termination dates
• Hospice name, address, and effective/termination dates
• Date of death
• Corrected Medicare number

At any time during eligibility playback the caller can give the next Medicare number if multiple eligibility
requests are needed.