General
These are currently the most asked questions at our Provider Contact Center. Please read the Q&A below to see if we can help you with your inquiry.
- Can you tell me how much was paid on my claim?
- I would like to know what happened with my claim. Can I request claim status from a CSR?
Can you tell me how much was paid on my claim?
Per the CMS publication 100-09, chapter 6, section 50.1, it states:
'Providers shall be required to use IVRs to access claim status and beneficiary eligibility information.' Our customer service representatives (CSRs) are now required to transfer providers back into the IVR for claim status requests. The IVR provides the amount paid on a claim, including a check or EFT number. This information can be obtained under 'Claim Details.'
You can access our IVR quick reference guide for information.
(Question based on October 2008 top telephone inquiries)
Date Posted: 11/20/2008, Date Reviewed/Revised: 12/16/2008
I would like to know what happened with my claim. Can I request claim status from a CSR?
Per the CMS publication 100-09, chapter 6, section 50.1, it states:
'Providers shall be required to use IVRs to access claim status and beneficiary eligibility information.'
Our customer service representatives (CSRs) are now required to transfer providers back into the IVR for claim status and beneficiary eligibility requests. The only time a claim status or eligibility inquiry will be serviced by a CSR is if the CSR is unable to successfully obtain the information from the IVR.
Providers need to have the following information available when calling the IVR to obtain claim status
1) NPI and Provider Transaction Access Number (PTAN)
2) Patient's correct HIC number
3) Patient's correct last name & first initial
4) Date(s) of service
For your convenience we have an "IVR Name To Number Conversion" tool that was created to assist providers who prefer to key the beneficiary's name rather than speak it. Simply type the beneficiary's name, press the convert button and the name will be converted to the number that is required by the IVR. The tool is located on-line. The number to call the IVR is 1-877-235-8048. Also, there is a quick reference guide for using the IVR.
(Question based on September 2008 top telephone inquiries)
Date Posted: 09/11/2008, Date Reviewed/Revised: 12/16/2008