Provider Update Newsletter
February 2008, Volume 184
All Providers
Attention All Medical Assistance Providers
Recipient Eligibility verification System (REVS)
Reminders
Valuable WEB Features
Attention All Medical Assistance Providers
EDS continues outreach efforts to obtain your
National Provider Identifier (NPI). Currently we have received NPIs from
89% of the participating Rhode Island Medical Assistance Providers. If
you have not submitted your NPI along with your Taxonomy and Provider
Legacy ID, please do so as soon as possible. In order to process your
claims, this information is necessary.
EDS along with The Department of Human Services (DHS) urges you to
forward your CMS approved e-mail, to Provider Enrollment by faxing a
hard copy to 401-467-9581 or send by e-mail to RI-CSHelpDesk. Please be
sure to include your taxonomy information and your current RI Medical
Assistance Provider ID on the correspondence.
RI Medical Assistance will be implementing a phased in approach for
providers. Page 2 contains a schedule of February compliance dates for
providers.
Please be aware that any claim submitted electronically to RI Medical
Assistance after 5:00 PM on the compliance date must contain a NPI and
taxonomy. RI Medical Assistance will no longer accept your legacy number
(Provider ID). Any claims submitted electronically, after this
deadline without an NPI and Taxonomy will be denied.
If you would like more information about NPI, please visit the DHS
website by clocking here and click
on the link for the What’s NEW section. You will find helpful
information regarding these changes.
The Department of Human Services and EDS appreciates your assistance and
support with this project.
|
Date NPI
Required
|
Provider
Type Description
|
|
|
Home
Health Agency |
|
|
Nursing
Home |
|
|
Severely
Disabled Children |
|
|
Personal
Care Aide / Assistant |
|
2/11/2008
|
Home /
Center Based Therapeutic Svcs |
|
|
Assisted
Living Facility |
|
|
MR Rehab |
|
|
Early
Intervention |
|
|
MR Waiver -
Private |
|
|
Freestanding
Dialysis |
|
|
|
|
|
Case
Manage / Social Worker |
|
|
Substance
Abuse Rehab |
|
|
CMHC /
Rehab Option |
|
2/25/2008
|
Other
Therapies / PT, OT, SHL |
|
|
Psychologist |
|
|
Hospice |
|
|
Chiropractor |
|
|
Group
Practice |
|
|
Ambulance |
Recipient Eligibility Verification System
(REVS) Reminders
The REVS line may be reached by calling
401-784-8100, or 1-800-964-6211 for in-state toll calls.
Using the keypad reference guide below to convert your alpha numeric
provider number, REVS can assist you when inquiring on a clients’
eligibility.
-
For dates of service (DOS) within the last year,
enter the specific date or span of dates
-
For DOS over one year, a representative can
assist you by dialing “0” through the voice response prompts
-
Listen carefully to the benefit information
which includes other insurance coverages
-
A verification number is also provided at the
end of the call, which does not guarantee eligibility, this number
is provided even when a client is not eligible.
-
An alpha numeric Provider Legacy ID can be
entered into the voice response system by converting the letters to
numbers. For an example, “A” can be entered as *21. Since “Q” and
“Z” do not appear on the telephone keypad, these two letters are
treated as if they are the first and second characters of key number
1. Below is the quick reference guide for converting letters to
numbers for the REVS line
-
All voice prompts request to be followed by the
# sign
|
A = *21 |
 N
= *62
|
|
B = *22 |
O = *63 |
|
C = *23 |
P = *71 |
|
D = *31 |
Q = *11 |
|
E = *32 |
R = *72 |
|
F = *33 |
S = *73 |
|
G = *41 |
T = *81 |
|
H = *42 |
U = *82 |
|
I = *43 |
V = *83 |
|
J = *51 |
W = *91 |
|
K = *52 |
X = *92 |
|
L = *53 |
Y = *93 |
|
M = *61 |
Z = *12 |
Entering your National Provider Identifier will
also allow you access to this information. The Department of Human
Services (DHS) website is another available resource for reference by
click here, listed under the MMIS
Web Transactions.
Valuable Web Features
RI Department of Human Services (DHS) Website
- www.dhs.ri.gov
DHS Electronic Claims Submission -
https://www.dhs.ri.gov/secure/logon.do
EDS in conjunction with The Department of Human
Services maintains the DHS website offering interactive services which
you can benefit from.
By filling out a Trading Partner Agreement, which is located on the DHS
website by clicking
here, the following services are available to assist your office
staff.
-
Eligibility Verification – Verify recipient
eligibility and print the information for file documentation
-
Prior Authorization Status – Check the status of
a prior authorization request
-
Remittance Advice Payment Amount – Confirm your
medical assistance payment history for the last 12 months
-
NDC Search – Pharmacies will be able to search
for a National Drug Code reimbursable by RI Medical Assistance
-
Claim Status – Check the status of a submitted
claim
|
