Part B IVR Operating Guide – Claim Status

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Part B IVR Operating Guide – Claim Status

Published on Feb 11 2020, Last Updated on Jun 07 2021

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Jurisdictions: J8B,J5B

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Touch-Tone Option	Vocal Option
2	“Claim Status”

To Use:

Say or enter the patient’s Medicare number
Say or enter the patient’s first and last name as it appears on the Medicare card
Say or enter the date of service (DOS)
Say or enter “claims” to hear the claim status information or say or enter “operator” if you already have the claim status details and need assistance from an agent.

Claim Status Information Available:

Assigned Claim

The date WPS GHA received the claim
Number of claims for the DOS
Status of the claim – denied, paid, or pending
Amount submitted
Allowed amount
Amount applied to the deductible
Amount paid
Paid date
Check number
Crossover information (if applicable)
On adjusted claims, the date and amount the original claim paid

Non-Assigned Claims

Number of claims for the DOS
Status of the claim – denied, finalized, or pending
Crossover information (if applicable)

After You Receive Initial Claim Information, You Can:

Say “repeat that” or press 1
Say “claims detail” or press 4
Say “operator” or press 0
Say “next claim” or press 2
Say “previous claim” or press 3
Say “Duplicate remittance notice or press” 5
Say “additional PTAN information” or press 6 (if more claims are available)
Say “change date” or press 7
Say “change Medicare number” or press 8
Say “change the PTAN” or press 9
Say “change the NPI” or press 10
Say “main menu” or press 11

Detailed Claim Information Available for Assigned Claims Only:

Claim control number
Number of line items and the following specific line item information
DOS
Procedure code
Modifier
Amount submitted
Allowed amount
Reason for denial

For denied claims, you will hear the ANSI reason and remark codes, patient liability, and additional information regarding the denial (if available). This includes items to check and steps to take to correct your claim if necessary.

After You Receive Detailed Claim Information, You Can:

Say “repeat that” or press 1
Say “next claim” or press 2
Say “previous claim” or press 3
Say “operator” or press 0
Say “duplicate remittance” or press 5 (for assigned claims only)
Say “additional information” or press 6 (if more claims are available)
Say “change date” or press 7
Say “change Medicare number” or press 8
Say “change the PTAN” or press 9
Say “change the NPI” or press 10
Say “main menu” or press 11

global-tags: J8B,J5B

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NPI_MODAL_PART_B_TITLE	NPI_MODAL_PART_A_TITLE
J5B RADIO NPI_MODAL_J5B_RADIO	J5A RADIO NPI_MODAL_J5A_RADIO
INB NPI_MODAL_INB_RADIO	NTA NPI_MODAL_NTA_RADIO
MIB NPI_MODAL_MIB_RADIO	INA NPI_MODAL_INA_RADIO
	MIA NPI_MODAL_MIA_RADIO

Part B IVR Operating Guide – Claim Status

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Part B IVR Operating Guide – Claim Status

global-tags: J8B,J5B