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IVR Conversion Tool

PTAN and Medicare Number Conversion

Name Conversion

 
 

Interactive Voice Response (IVR)

Access the below IVR related information from this page.

Availability

  • General IVR inquiries available 24/7
  • Claim-specific inquiries available: Monday-Friday: 6 a.m. - 8 p.m. CT, Saturday: 7 a.m. - 4 p.m. CT
  • 877-908-8431

Call-in Tips

  • It is important that callers listen to the IVR prompts as they will provide navigational instructions
  • Call from a quiet environment using a telephone with a handset or headset
  • Use of speaker phones and cell phones is not recommended
  • Speak clearly and naturally into telephone
  • Bypass upfront messaging by saying "Main Menu" or pressing # key on telephone keypad
  • Selections may be keyed or spoken without waiting for entire prompt to play
  • Say "Main Menu" at any time to go back to beginning of call flow
  • If IVR is having difficulty with information as spoken, try keying information with telephone keypad
  • Enter full Medicare number

If callers prefer to avoid the voice-recognition option offered from the IVR, use the IVR Conversion Tool to assist in determining the touch-tone data-entry.

Authentication Elements

To ensure that calls flow as quick and as productive as possible, be prepared with the below information. Depending on the inquiry and department, additional authentication details will be necessary. Failure to provide the IVR with all necessary information may result in inaccurate or incomplete returned results.

Provider Details

  • NPI - National Provider Identifier
  • PTAN - Provider Transaction Access Number
  • TIN - Tax Identification Number (Last five digits)

Beneficiary Details

  • Beneficiary Name
  • Beneficiary Medicare Number
  • Beneficiary Date of Birth
  • Date of Service

Touch Tone Feature for Entering Letters

To enter a numeric value, use the corresponding number on telephone keypad. The three-key combination works as follows.

  • Select *(star) key
  • Select key on telephone keypad which contains letter
  • Select key which represents position of letter on keypad
  • Example: PTAN 55t551     Key Entry: 55*81551
View the complete listing of letters and their corresponding three-key combinations
  • A *21
  • B *22
  • C *23
  • D *31
  • E *32
  • F *33
  • G *41
  • H *42
  • I *43
  • J *51
  • K *52
  • L *53
  • M *61
  • N *62
  • O *63
  • P *71
  • Q *72
  • R *73
  • S *74
  • T *81
  • U *82
  • V *83
  • W *91
  • X *92
  • Y *93
  • Z *94

Route Call in the Right Direction

Main Menu

All calls begin at the Main Menu where a caller is immediately able to choose the desired customer service area, from below table, in which to direct his/her inquiry to. Note: The touch tone options are not provided during this initial prompt, so it is best to have this information ready when calling.

During Noridian business hours, callers may say "operator," "agent", or press "0" (zero) to be transferred to a Customer Service Representative when the IVR is unable to complete the desired inquiry and/or there are still questions about the information it did provide.

When navigating within the IVR, callers may speak "Main Menu" to return to this high-level menu option.

IVR Guide

Part A or Part B General Inquiries

Verbal Response: General | Touch Tone Response: 1

Future eligibility dates are not accepted.

Verbal Response: Eligibility| Touch Tone Response: 1
Submenu Item Verbal Option Touch Tone Option
General
  • Part A and B effective/termination dates
  • Last billing dates
  • Hospital Inpatient, Skilled Nursing Facility (SNF), Lifetime Reserve Benefits Day
  • Deductible information for year of date of service
 General Eligibility 1
MSP
  • Is there an MSP on file
  • MSP type, name, address (if available), policy number
  • Effective/termination date
 MSP 2
HMO
  • If patient has an HMO
  • HMO name, type, plan code number, address (if available), phone number
  • Effective/termination date
 HMO 3
Home Health
  • Is there a home health care file
  • Earliest/latest date of home health
 Home Health 4
Hospice
  • Is there a hospice file
  • Earliest/latest date of hospice
 Hospice 5
Preventive Preventive 6
Details
  • Physical and Occupational Therapy limits
  • Skilled Nursing Facility (SNF)
    • Is there a Part A stay which may include SNF
    • Earliest/ latest date of Part A stay
  • Pneumococcal Vaccine
    • Indicate if it's been received or next eligible date
  • Blood Deductible
  • Date of Death
    • Date of death on file, if applicable
 Eligibility Details 7
Verbal Response: Claim Status | Touch Tone Response: 2

Additional Provider Authentication Elements

  • Patient Medicare number
  • Start and end date of service
  • Patient name as it appears on Medicare card

At any time, caller may:

  • Change Medicare number, NPI, or PTAN number

Claim Status Provides

  • Number of Claims (in given date range)
  • Claim Status (processed, denied, pending, etc.)
  • Receipt Date
  • Date(s) of Service
  • Type of Bill
  • Total Charges
  • Claim Location – e.g. SB9000, TB9997

Caller Must Say "Details" to Hear

  • Finalized Date
  • Processed Medicare Primary/Secondary
  • Reason Code and Narrative
  • Provider Reimbursement
  • Deductible and Coinsurance Applied
  • Patient Responsibility
  • Total Non-covered Charges
  • Check Number
  • Document Control Number (DCN)
  • Liability of Denied Claims
Verbal Response: Financials | Touch Tone Response: 3
Submenu Item Verbal Response Touch Tone Response
Remittance Information

Caller must enter or say remit date to hear the below

  • Breakdown of Remittance Advice (RA) information
  • Check information
 Remittance Information 1
Check Information

Single Check

Caller must enter or say the check date to hear the below

  • Single check number, issue date, and amount

Last Three Checks

Caller must say Last three to get below

  • Check issue numbers, issue dates, and amounts
 Check Information 2
Verbal Response: Patient Status | Touch Tone Response: 4

Additional Provider Authentication Elements

  • Patient Medicare number
  • Patient gender
  • Patient first and last name
  • Patient date of birth
  • End date of claim

Patient Status Provides

  • Inpatient, hospice period, or home health episodes for date of service, if applicable
Verbal Response: Remark Codes | Touch Tone Response: 5

Remark Codes Provides

  • Description of code in question (also available on X12 website)

EDI

Verbal Response: EDI | Touch Tone Response: 2

This selection is for calls related to EDI Connect, Gateway or electronic file assistance

Note: Vendors who do not have a specific NPI or PTAN available, say Agent to speak with a representative.

Enrollment

Verbal Response: Enrollment | Touch Tone Response: 3

This selection is for calls related to PECOS and Medicare provider enrollment assistance

Is the inquiry regarding mailing addresses, application fees, or application status information?

Verbal Response

  • Say Yes - Caller will be directed to website for additional information based on his/her selection
  • Say No - Caller must provide the Provider Authentication Elements

Note: If caller does not have a specific PTAN assigned, he/she must state whether call is related to Part A or Part B.

Reopenings

Verbal Response: Reopenings | Touch Tone Response: 4

Caller must provide Provider Authentication Elements and Internal Control Number (ICN) of claim he/she wishes to reopen.

User Security

Verbal Response: User Security | Touch Tone Response: 5

This selection is for calls related to Direct Data Entry (DDE) or Noridian Medicare Portal (NMP) registration and/or password assistance.

Resource

Last Updated Oct 04 , 2024