Last Modified: 2/5/2010
Location: FL, PR, USVI
Business: Part A
The Centers for Medicare & Medicaid Services (CMS) {formerly known as the Health Care Financing Administration) records indicate the beneficiary is not in file. Please verify the beneficiary's identification and submit a new claim.
Tips
When a beneficiary comes to your facility you should ask a few questions to verify their eligibility. Those questions could be:
1. Do you have a Red/White/Blue Medicare card?
2. Have you recently moved from another state?
Once you have the answers, verify the beneficiary eligibility prior to submitting the claims. There are a few ways to obtain this information:
• Direct data entry (DDE) users can pull the eligibility information by using the ELGA (eligibility A) or HIQA (health insurance query A) screens.
• Contact the interactive voice response (IVR) unit.
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Source: FCSO Education Action Team
T5052