Verify services for Medicare Safety Net 011-43080050

Current calendar year search:

• Key NSCI, card number
• Press [Enter]

The services that require verification display.

Previous calendar year search:

• Key NSCI,card number,from/ddmmyy e.g. for 2019 calendar year use control line 'NSCI,cardnumber,from/010119'
• Press [Enter]

The services that require verification display.

• Key ‘S’ in the S (select) field for each service to be verified
• Press [Enter]

Note: confirm the amount displayed in the SUBS-AMT field is the same as the amount for substantiation on the receipt supplied by the claimant.

If the safety net threshold has not been reached:

• enter date Medicare received the receipt which required verification in the DOL field (for online claims the DOL from the provider)
• change the 'I' to a 'U' on the NSCI control line
• press [Enter]

If the safety net threshold has been reached:

• in the claimant field enter the claimants Medicare card number (if different from the original claimant displayed)
• in the REF field key the claimants reference number as per their Medicare card
• enter date Medicare received the receipt which required verification in the DOL field (for online claims the DOL from the provider)
• confirm the EFT details are correct and key ‘C’ in the EFT field
• key ‘P’ in the STM field to indicate the customer has requested a statement to be sent
• press [Enter]

The system displays the amount that has been verified against the safety net and the amount that is payable to the claimant.

• Overkey control line NSCC with NSCU
• Press [Enter]

Note: do not erase any part of the card number.

Press U TO ADJ.

The office copy of the receipt displays.

Press [Print Screen].

The first page of the office copy of the receipt is printed on the desktop printer.

Press F8 FORWARD.

The signatory page of the office copy of the receipt displays.

Press [Print Screen].

The signatory page of the office copy of the receipt is printed on the office printer.

Get the claimant's or Authorised Agent's signature and retain the receipt.

Press F8 FORWARD.

The claimant copy of the receipt displays.

Press [Print Screen].

The claimant copy of the receipt is printed on the office printer.

If the claimant receipt continues across more than 1 page, continue the following process until the end of the claimant receipt:

• press F8 FORWARD
• press [Print Screen]

Upon completing the printing process, issue the claimant with the claimant copy of the receipt.

• Key NSCI, card number
• Press [Enter]

• key S (select) in the select field of the lines to verification
• press [Enter]

The verification amount is displayed in the SUBS-AMT field.

Overkey the amount shown in the SUBS-AMT field with 0.00 and press [Enter].

The amount entered is validated.

Press U TO ADJ.

The history screen reflects a $0.00 amount for that item in the SUBS-AMT field [F6] view.

Place the cursor under the amount in the Fee field and press [F1].

The amount to be verified is displayed as Patial Payment amount.

Take note of the patient’s Medicare card number.

Pay the claim and verify the claim using the NSCI control line:

• See Table 1 in Verify services for Medicare Safety Net
• Select the services to be paid

Note: Service Officers need to confirm amount to be verified is correct on the NSCI screen before updating.

The return message 1- SNET PEND is displayed where partial payment is:

• greater than the out of pocket amount
• less than the out of pocket amount

Key ‘P’ in Payee code field and RSN 388 to pend items.

For reason codes refer to Indicators, codes, modifiers and control lines for claims processing in Medicare.

Note:

• Service Officers must complete this step
• all documentation must be forwarded for processing to MPS Assessing