Last Modified: 7/7/2011
Location: FL
Business: Part A
Beneficiary demographic/eligibility/entitlement inquiry
If you have questions on the beneficiary's Medicare demographic or eligibility information, which could include the date of birth, date of death, entitlement dates, benefit dates, deductible or coinsurance, you can access the information by using one or more of the options below:
• Note: Customer service representatives cannot assist you with eligibility information and are required, by the Centers for Medicare & Medicaid Services (CMS), to refer you to the IVR.
• Direct data entry (DDE)
users -- by using the ELGA (eligibility A) screen, you can obtain eligibility information on any beneficiary for whom you are submitting claims.
• 270/271 eligibility transactions
-- this is also a real time inquiry, and you can obtain the eligibility information in a batch format for a number of beneficiaries.
Source: FCSO Education Action Team