You use the Eligibility Confirmation Search page to determine whether a provider had received a Yes confirmation on a member eligibility inquiry before the provider rendered services to that member and the denied claim should be paid.
The Eligibility Confirmation Search page contains the following panels:
| Field | Description |
|---|---|
| Confirmation ID |
The confirmation ID provided to the provider at the time they checked on the eligibility of a member's benefits. |
| Member ID |
Unique identifier used for a member and is assigned when the member becomes eligible to receive Medicaid benefits. |
| Member ID Type |
Unique code indicating the type of member identification. Examples: Member ID, Medicaid ID, Medicare ID, SSN |
| Provider ID |
Unique identifier used for a provider of healthcare services. Format: Up to 15 alphanumeric characters |
| Provider ID Type |
Unique code that indicates the type of provider ID entered. Examples: DEA, NPI, SSN/EIN |
| Confirmation From Date | The starting confirmation date entered by the provider when he/she did an eligibility search on member's benefits and received a confirmation. |
| Confirmation To Date |
The ending confirmation date entered by the provider when he/she did an eligibility search on the member's benefits and received a confirmation. Tip: Use both dates when searching over a range of several days. |
| Field | Description |
|---|---|
|
If more than one match is found, this table is displayed. To view a match, click the appropriate row. None of these fields can be edited. |
|
| Confirmation ID | The confirmation ID provided to the member at the time they became eligible for benefits. |
| Member ID |
Unique identifier used for a member and is assigned when the member becomes eligible to receive Medicaid benefits. |
| Member ID Type |
Unique code indicating the type of member identification. Examples: Member ID, Medicaid ID, Medicare ID, SSN |
| Member Name |
The name of person associated with the member ID. |
| Provider ID |
Unique identifier used for a provider of healthcare services. Format: Up to 15 alphanumeric characters |
| Provider ID Type |
Unique code that indicates the type of provider ID entered. Examples: DEA, NPI, SSN/EIN |
Version as of 5/16/14.
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