Automated Voice Response Eligibility Verification Subsystem Call Flow Manual

[502] ... and first name is ... .

[503] ... carrier remaining.

[504] ... carriers remaining.

[505] ... carriers.

[506] ... Denied ...

[507] ... from ...

[508] ... has ...

[509] ... has been ...

[510] ... has KenPAC ...

[511] ... has Lock In ...

[512] ... has Lock In for a portion of the requested dates.

[513] ... is ...

[514] ... is eligible for a portion of the requested dates ...

[515] ... is eligible for Managed Care behavioral health in region ...

[516] ... is eligible for Managed Care physical health in region ...

[517] ... is eligible for Medicaid benefits ...

[518] ... is eligible for Medicare co-insurance and deductible payment only.

[519] ... is in ...

[520] ... is not authorized to receive PRO Information.

[521] ... is not eligible for Medicaid benefits ...

[522] ... is not on file for provider.

[523] ...is not on file.

[524] ... KenPAC segments remaining.

[525] ... Lock In segment remaining.

[526] ... Managed Care segments remaining.

[527] ... Managed Care segments.

[528] ... mini-adjudication cycle ...

[529] ... no remittance is found.

[530] ... Not Available ...

[531] ... on ...

[532] ... Paid for amount of ...

[533] ... press 0.

[534] ... press 1.

[535] ... press 2.

[536] ... press 3.

[537] ... press 4.

[538] ... press 5.

[539] ... press 6.

[540] ... press 7.

[541] ... press 8.

[542] ... press 9.

[543] ... press star star.

[544] ... in process ...

[545] ... provider name is ...

[546] ... provider phone number is ...

[547] ... Stay Days.

[548] ... Suspended ...

[549] ... Suspended and ready to Process ...

[550] ... Suspended and ready to be Deleted ...

[551] ... Suspended with a credit or adjustment ...

[552] ... tape billing cycle ...

[553] ... the managed care organizations telephone number is ...

[554] ... through ...

[555] ... to be deleted from Suspended Transaction ...

[556] ... To Be Denied ...

[557] ... To Be Paid ...

[558] ... was for amount of ... .

[559] ... was performed on ... .

[560] ... with Check Digit ... .

[561] ... with policy number ...

[562] ... with reference number ...

[563] ... Echo exam follow-up or repeat ... .

[564] Currently all Customer Service Representative lines are busy.

[565] Currently the system is unable to process your request.

[566] For assistance from a Customer Service

Representative, please call back between 8:00 AM to 6:00 PM,

except weekends and holidays, and we'll be happy

to assist you.

[567] For assistance from a Customer Service Representative, press 0.

[568] For Card Issuance information, press 7.

[569] For claim status, press 5.

[570] For Co-Pay information, press 4.

[571] For eligibility verification, KenPAC, third party

liability, provider check write, lockin, claim

status, managed care, PRO Review Information, Card

Issuance or Co-Pay information, press 1.

[572] For eligibility verification, press 1.

[573] For example, July 01, 1995 would be entered as

zero seven, zero one, nineteen, ninety-five.

[574] For information on Service Limitations for this member, press 8.

[575] For inquiring on a ICN or TCN, press 1.

[576] For KenPac information, press 2.

[577] For KenPAC, TPL, Lockin, Service Limitations,

managed care or Co-Pay information, press 2.

[578] For Lockin verification, press 6.

[579] For Managed Care information, press 5.

[580] For Newborn eligibility verification, please press 4.

[581] For prior authorization Information, press 6.

[582] For Provider Check Write, press 4.

[583] For provider number ...,

[584] For Service limitations, press 8.

[585] For Standard eligibility verification, press 5.

[586] For the 9 digit member Check Digit information, press 3.

[587] For TPL information, press 3.

[588] If this concludes your call, you may hang up.

[589] If you do not have a ICN or TCN, press 2.

[590] If you would like assistance from a Customer Service Representative, press 0.

[591] Invalid option.

[592] Invalid provider number.

[593] Invalid ICN or TCN number ... .

[594] Newborn using mother's member number ...,

[595] No PRO information was found for member number ...,

[596] Please call again later.

[597] Please call back and we'll be happy to assist you.

[598] Please contact Provider Services if you need further operating assistance.

[599] Please enter 1 if the member is male. Please enter 2 if the member if female.

[600] To validate by Social Security Number, press 1.

[601] Please enter the billed amount for member.

[602] Please enter the eight digit from date-of-service

in month, day, century, year format followed by

the pound sign, or enter a pound sign only for

today's date.

[603] Please enter the eight digit member date-of-birth

in a month, day, century, year format.

[604] Please enter the eight digit TO date-of-service in

a month, day, century, year format followed by

the pound sign or enter a pound sign only if the To

date of service is the same as the FROM date of

service.

member's first name. Enter an asterisk followed by the

2-digit code for the letter. After the 2-digit

code has been entered, press the pound key. For

further instructions, press 1 followed by the pound key.

[606] Please enter the first five characters of the

member's last name. Enter an asterisk followed by the

2-digit code for each letter. After the fifth

letter has been entered, press the pound key. For

further instructions, press 1 followed by the pound

key.

[607] Please enter the nine digit member ID

[609] Please enter the PRO Reference number.

[610] Please enter the member's Social Security

[611] Please enter the ten-digit Medicaid member ID number of the newborn's mother.

[612] Please enter the ten-digit Medicaid member ID number.

[613] Please enter your eight-digit or ten-digit Medicaid Provider ID number.

[614] Please enter your thirteen digit ICN or seventeen digit TCN,

[615] Please hold for a Customer Service Representative.

[616] Please re-enter your seventeen digit TCN number.

[617] Please re-enter.

[618] Please try again later.

[619] Please verify the Kentucky Medicaid member Card.

[620] Please wait while the requested information is retrieved.

[621] Member ...

[622] Member number ...

[623] Member number for newborn ...

[624] ICN ...

[625] Thank you for calling the Kentucky Voice Response System.

[626] Thank-you for calling the Kentucky Voice Response

Eligibility Verification System.

[627] That date is not valid.

[628] That entry is invalid.

[629] That entry is not valid.

[630] The claim for provider ...

[631] The information given is subject to change without notice.

[632] The member ...

[633] The member has ...

[634] The member has an insurance policy with ...

[635] The member has insurance policies with ...

[636] The member has no Managed Care eligibility.

[637] The member is not insured by another carrier.

[638] The member's last name is ...

[639] The remittance on ...

[640] There are ...

[641] There are no claims found for ... .

[642] There is ...

[643] This claim requires further assistance.

[644] This does not indicate any eligibility status or information.

[645] This member has ...

[646] This member has more than one TCN with the same billed amount.

[647] This member has partial KenPac for coverage.

[648] This member has partial Managed Care for coverage.

[649] To continue, press 2.

[650] To get more information about this member's KenPAC information, press 2.

[651] To hear information for the next insurance carrier, press 1.

[652] To hear information for the next KenPAC segment, press 1.

[653] To hear information for the next Lock In segment, press 1.

[654] To hear information for the next Managed Care segment, press 1.

[655] To hear the member's name, press 6.

[656] To inquire about another member's Co-Pay information, press 4.

[657] To inquire about another member's Managed Care coverage, press 3.

[658] To inquire about another member's Managed Care information, press 3.

[659] To inquire about another member's Plastic Card Issuance data, press 7.

[660] To inquire on another claim status, press 5.

[661] To inquire on another member's Eligibility, press 1.

[662] To inquire on another member's Lock In information, press 7.

[663] To inquire on another member's PRO Review Information, press 2.

[664] To inquire on another member's service limitation, press 2.

[665] To inquire on another member's Third Party Liability information, press 3.

[666] Invalid ICN

[667] To inquire using Medicaid number, press 1.

[668] To re-enter the PRO Reference Number, press 1.

[669] ... has been paid for the amount of ...

[670] To skip the remaining carrier information, press 2.

[671] To skip the remaining KenPAC segment information, press 2.

[672] To skip the remaining Lock In segment information, press 2.

[673] To skip the remaining Managed Care segment information, press 2.

[674] To skip the remaining segment information, press 2.

[675] We are open from 8 AM to 6PM except weekends and holidays.

[676] We are unable to process dates beyond ... .

[677] We are unable to process dates older than ... .

[678] We're sorry our office is closed for the holiday.

[679] We're sorry you have not entered the required data at this step.

[680] We're sorry, our office is closed.

[681] We're sorry, provider number ...

[682] We're sorry, provider number is not authorized.

[683] Welcome to the Kentucky Voice Response Eligibility Verification System.

[684] With KCHIP Phase III eligibility

[685] With partial KCHIP Phase III eligibility

[686] You have met the maximum of five inquiries.

[687] Goodbye

[688] ... is invalid.

[689] To inquire using the members name, press 2.

[690] Invalid billed amount.

[691] To return to the main menu, press star 99.

[692] Please select one of the following options

[693] ... followed by the pound sign.

[694] ... or ...

[695] For an explanation of special automated voice

response system features, press 2.

[696] The AVRS uses 2 special function keys - the pound

sign and the asterisk or star keys. The pound sign

key must always be used at the end of any

touch-tone keypad entry. For example, if you are prompted

to enter your user id of 1234567, you must enter

1234567 and the pound sign on the touch-tone keypad.

[697] If you wish to have the system repeat the last

inquiry response, press the asterisk key once and

then the pound sign. If you wish to have the system

repeat the last prompt, press the asterisk key twice

and then the pound sign. If you wish to return to

the main menu, press star 99 and the pound sign at

any prompt.

[698] Since the telephone touch-tone keypad has only

numeric digits 0 through 9, a special method must be

used to allow callers to enter alphabetic

characters. To enter alphabetic data, press the asterisk key

followed by a two-digit numeric code. This

numeric code represents a specific alphabetic character.

The first digit corresponds to the key cap number

on which the character appears. The second digit

corresponds to one of the three alphabetic characters

on the key cap. Therefore, the code *-2-1 is used

to input the letter "A" since the letter "A"

appears in position one on key cap two on the touch-tone

keypad. The characters "Q" and "Z" do not appear

on the touch tone keypad. Therefore, these two

characters are treated as though they are the first

two characters on key cap one. For example, to enter

"Q", enter *-1-1. To enter "Z", enter *-1-2.

[699] You have selected ...

[700] Press 1 to confirm this selection.

[701] Press 2 to change your selection.

[702] Invalid last name.

[703] Invalid first name

[704] ... is not authorized.

[705] To validate by Date of Birth, press 2.

[706] ... press star nine nine

[707] ... and ..

[708] KenPac

[709] Medicare ...

[710] Third Party Liability

[711] Lockin

[712] ... is in tape billing cycle

[713] ... is suspended

[714] ... is suspended and ready to process

[715] ... is suspended and ready to be deleted

[716] ... is suspended with a credit or adjustment

[717] ... is a reversed claim to be credited

[718] ... is to be paid

[719] ... is to be denied

[720] ... has been denied

[721] ... is to be deleted from suspended transaction

[722] ... is in min-adjudication cycle.

[723] ... is eligible for services for the date

[724] ... with county code ..

[725] ... KCHIP coverage ...

[726] ... KenPac coverage

[727] ... Lock-in coverage

[728] ... Partial KCHIP coverage ...

[729] ... partial KenPac coverage

[730] ... Partial Lock-in coverage

[731] ... no KenPac coverage

[732] ... no Lockin coverage

[733] ... Hospice coverage

[734] ... Partial Hospice coverage

[735] ... no Hospice coverage

[736] ... Medicare coverage

[737] ... Partial Medicare coverage

[738] ... no Medicare coverage

[739] ... Third party Liability coverage

[740] ... Partial Third party Liability coverage

[741] ... no Third party Liability coverage

[742] Co-pay applies for the time frame entered.

[743] Co-pay applies for a portion of the time frame entered.

[744] Co-pay does not apply for the timeframe entered.

[745] Prophylaxis Adult

[746] Prophylaxis Child

[747] Sealant

[748] Space Maintainer-fixed unilateral

[749] Space Maintainer-fixed bilateral

[750] Space Maintainer-removable unilateral

[751] Space Maintainer-removable bilateral

[752] Pin retention

[753] Replace missing/broken teeth, denture

[754] Repair resin saddle or base

[755] Repair cast framework

[756] Replace broken teeth, per denture

[757] Reline complete maxillary denture

[758] Reline lower complete denture

[759] Transitional Appliance

[760] Alveoloplasty in conjunction with extractions-per quadrant

[761] Alveoloplasty not in conjunction with extractions-per quadrant

[762] TMJ

[763] Removable appliance therapy

[764] Fixed appliance therapy

[765] Orthodontic Exam

[766] Fitting of spectacles-monofocal

[767] Fitting of spectacles-bifocal

[768] Fitting of spectacle prothesis for aphakia monofocal

[769] Fitting of spectacle prothesis for aphakia multifocal

[770] Repair and fitting of spectacles

[771] Frame temple/front

[772] New patient office visit or other outpatient services.

[773] Frames

[774] Lens

[775] Hinge repair

[776] Established patient office visit or other outpatient services

[777] Echo exam of pregnant uterus

[778] Echo exam follow up or repeat

[779] Echo exam transvaginal

[780] Prophlaxix

[781] Echo exam of fetal heart

[782] Echocardigraphy, fetal cardiovascular system, real

time with image documentation,follow up or repeat

study.

[784] ... KenPac segment remaining.

[785] Our files show no service limitations at this time for member ...

[786] ... carrier.

[787] ... has no Lockin ...

[788] ... Lockin segments remaining.

[789] PRO Reference number ...

[790] ... has a card issued on ...

[791] ... with beginning coverage date of ...

[792] ... Managed Care segment remaining.

[793] The To date of service cannot preceed the From date of service.

[794] I need a valid date that is not in the future.

[795] Invalid From Date of Service

[796] Invalid To Date of Service

[797] The member has Managed Care eligibility.

[798] For beneficiary...

[800] This member is enrolled in the...

[801] ...and dates of service from...

[802] ...billed for...

[803] ...on RA...

[804] Provider number...

[805] ...PA requests found.

[807] ... a beneficiary...

[808] ...is approved.

[809] is dismissed approved.

[810] ...is denied in administrative review.

[811] ...is denied.

[812] ...is pending .

[813] is approved in Administrative Review.

[814] ...is cancelled.

[815] ... is in evaluation.

[816] .. is rejected.

[817] is dismissed denied.

[818] This member has accumulated...

[819] ...of the annual maximum of...

[820] ...PA requests finalized.

[821] is modified in administrative review.

[822] ...Procedure code ...

[823] ...Revenue code ...

[824] ...NDC...

[826] ...one unit ...

[827] ...units.

[828] ... is still available.

[829] ... are still available

[830] ... is authorized for ...

[831] To inquire on another member's Prior Authorization information, press 1.

[832] ...the status is unavailable

[833] Please enter the eight digit date-of-service in

month, day, century, year format followed by the

pound sign, or enter a pound sign only for today's

date.

[834] Our files show no prior authorization based on date-of-service...

[836] To skip the remaining prior authorization, press 2.

[837] Prior authorization number...

[838] ...for from procedure code...

[839] ...and to procedure code...

[840] and modifier

[841] ...for begin date...

[842] ...and end date...

[843] ...is approved.

[844] ...is denied.

[845] ...is pending.

[846] ...is used.

[847] ...is void.

[848] Please enter the eight-digit or ten-digit

rendering Medicaid Provider ID number, followed by the

pound sign, or enter the pound sign only if you are

the rendering provider.

[849] The from and to dates of service must be in a 13 month window.

[850] ... this claim is currently processing as of ...

[851] ...and dates of service from...

[852] ...billed for...

[853] ...on RA...

[854] There were...

[855] There was...

[856] ...claims found.

[857] ...claim found.

[858] For ICN...

[859] More claims exist for member number...

[860] ... but you have received the maximum allowed for this transaction.

[861] More claims exist. To hear the next one, press 1

followed by the pound sign, otherwise, press 2

[862] More PA Line items exist, to hear the next one...

[863] To check the number of stay days using a member number and PA Number, press 1.

[864] To check the status of a PA using a rendering

provider number, member number and date of service,

press 2.

[866] ...has no card issue on file.

[867] TCN...

[868] For TCN...

[869] The beneficiary has other insurance with...

[871] For beneficiary...

[872] ... was paid ...

[873] ... on RA...

[874] ...dated...

[875] ... a claim was paid ...

[876] ... a claim was denied ...

[877] ... was denied ...

[878] For more detailed claim information or EOB code

definition please refer to your remittance advice

or visit our web site at www.srskansas.org.

[879] For EOB...

[880] 1 sec pause

[881] 2 sec pause

[883] ... but you have received the maximum allowed for this transaction.

[884] ...and is eligible for the HCBS developmentally disabled waiver.

[885] ...and is eligible for the HCBS head injury waiver.

[886] ...and is eligible for the HCBS physically disabled waiver.

[887] ...and is eligible for the HCBS children's technology assisted waiver.

[888] ...and is eligible for the HCBS severe emotional disturbance waiver.

[889] ...and is eligible for the HCBS frail elderly waiver.

[890] ...and is in a nursing facility.

[891] ...and is in a state hospital.

[892] The beneficiary is assigned to the ...

[893] ...adoption support contracting agent, ...

[894] ...foster care contracting agent, ...

[895] ...contracting agent, ...

[896] There is no managed care plan on file.

[897] There is no restricted or lockin information on file.

[898] The fax has been created and will be sent at the conclusion of this call.

[899] Please call customer service at 800-285-4978 or

785-274-5499 for information on this line item.

[900] Welcome to the Text to Speech Test Application.

[901] Text to Speech Test Successful

[902] Text to Speech Test Failed. Check TextSpeech.Log for details.

[903] The National Drug Code you have entered is active.

[904] The National Drug Code you have entered is not active.

[905] ...and has EAC Drug pricing

[906] ...and has MAC drug pricing

[907] ...and is non-covered

[908] ...and requires manual drug pricing

[909] ...and is obsolete

[910] ...and has EAC pricing with prior authorization

[911] ...and has Federal Upper Limit pricing

[912] ...with Medicaid and MediKan coverage.

[913] ...with Medicaid coverage only.

[914] The coverage restriction is not available.

[915] Kan Be Healthy coverage is required

[916] Kan Be Healthy coverage is not required

[917] Prior authorization is not required.

[918] Prior authorization is required, please call 1-800-285-4978.

[919] Prior Authorization is required for EAC pricing, please call 1-800-285-4978.

[920] The billing unit is injectable Anti-Hemophilic Factor.

[921] The billing unit is capsule.

[922] The billing unit is suppository

[923] The billing unit is gram.

[924] The billing unit is milliliter.

[925] The billing unit is tablet

[926] The billing unit is transdermal patch.

[927] The billing unit is each.

[928] The medicaid reimbursement rate is

[929] The medicaid reimbursement rate is manually priced.

[930] This is a non-covered National Drug Code.

[931] This is a discontinued National Drug Code.

[932] ...with prior authorization.

[933] ...but pricing information is not available.

[934] The Kan Be Healthy coverage requirement can not be

determined for this NDC request.

[935] The prior authorization requirement can not be determined for this NDC request.

[936] The billing unit is not available.

[937] Pricing information can not be determined for this

request with the information provided.

[938] To transfer to a representative...

[939] To continue with your call...

[940] ...and is eligible for the program of all inclusive care for the elderly.

[941] ...and is in a level 6 facility.

[945] Welcome to the Text to Speech Test Application.

[946] Text to Speech Test Successful

[947] Text to Speech Test Failed. Check TextSpeech.Log for details.

[948] Welcome to the message test application. Enter message number...

[949] Welcome to the test line. For EVS, press 1. For

TTS Test, press 2. For message test, press 3.

[950] For vs appl, press 1. For vs sys, press 2. For vs altec, press 3.

[951] The system was not able to complete your fax request.

[952] To access the voice response system press 1. To

reset your voice response or internet pin, press 2.

To speak to EDI technical support regarding

electronic claims submission press 3.

[953] To reset your voice response PIN press 1 followed

by the pound sign. To reset you internet PIN press

2...

[954] For dates entered, Level 1 transportation services

[955] For dates entered, Level 2 transportation services

is the most current eligibility

[956] VS_SYS msg: 260

[957] Since the telephone touch-tone keypad has only

numeric digits 0 through 9, a special method must be

used to allow callers to enter alphabetic

characters. To enter alphabetic data, press the asterisk key

followed by a two-digit numeric code. This

numeric code represents a specific alphabetic character.

The first digit corresponds to the key cap number

on which the character appears. The second digit

corresponds to one of the three alphabetic characters

on the key cap. Therefore, the code *-2-1 is used

to input the letter "A" since the letter "A"

appears in position one on key cap two on the touch-tone

keypad. The characters "Q" and "Z" do not appear

on the touch tone keypad. Therefore, these two

characters are treated as though they are the first

two characters on key cap one. For example, to enter

"Q", enter *-1-1. To enter "Z", enter *-1-2.

[958] GetToDOS

[960] ...and is in a head or brain injury rehabilitation facility.

[980] The member is currently subject to co-payments.

This information is subject to change in the future.

Please check co-payment status for future claims.

[981] The member is not presently subject to

co-payments. This information is subject to change in the

future. Please check co-payment status for future

claims.

co-payments. This information is subject to change

in the future. Please check co-payment status for

future claims.

[983] The member is not presently subject to physician

co-payments. This information is subject to change

in the future. Please check co-payment status for

future claims.

[984] If you have submitted your enrollment application

within the last 30 days, your application is still

in process. If you need further assistance,

please call the Provider Enrollment call center at

877-838-5085

[985] To inquire using social security number, press 2.

[986] Please enter the Social Security Number of the newborn's mother.

[987] Newborn using mother's social seccurity number

[988] Social Security Number

[989] You entered ...