Verify services for Medicare Safety Net 011-43080050

This document outlines details about verification of services for Medicare Safety Net.

Note: from 1 July 2016, Norfolk Island is covered under Medicare provisions.

Step	Action
1	Key NSCI, card number 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.
2	Select services to be verified 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.
3	Key receipt date and payee code 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.
4	Overkey details Overkey control line NSCC with NSCU Press [Enter] Note: do not erase any part of the card number.

Print verification receipts

Table 2: This table describes how Service Officers print verification receipts when processing a verification claim Face-to-Face.

On completion of the verification process on the Substantiate patient contribution (NSCI) screen, if the claimant is entitled to a Medicare benefit payment, the message '8-FM SN U to ADJ SUBS AMT $nnn.nn PAY EFT BN $NNN.NN' displays.

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Step	Action
1	View office copy of receipt Press U TO ADJ. The office copy of the receipt displays.
2	Print office copy of receipt Press [Print Screen]. The first page of the office copy of the receipt is printed on the desktop printer.
3	View office copy signatory page Press F8 FORWARD. The signatory page of the office copy of the receipt displays.
4	Print office copy signatory page Press [Print Screen]. The signatory page of the office copy of the receipt is printed on the office printer.
5	Get signature Get the claimant's or Authorised Agent's signature and retain the receipt.
6	View claimant copy of receipt Press F8 FORWARD. The claimant copy of the receipt displays.
7	Print claimant copy of receipt Press [Print Screen]. The claimant copy of the receipt is printed on the office printer.
8	Determine if claimant copy continues across more than 1 page 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]
9	Issue claimant copy of receipt Upon completing the printing process, issue the claimant with the claimant copy of the receipt.

Change verification amount to zero

Table 3: screen name- Substantiate patient contribution (NSCI).

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Step	Action
1	Key NSCI, card number Key NSCI, card number Press [Enter]
2	Select field for verification key S (select) in the select field of the lines to verification press [Enter] The verification amount is displayed in the SUBS-AMT field.
3	Overkey amount Overkey the amount shown in the SUBS-AMT field with 0.00 and press [Enter]. The amount entered is validated.
4	Update history screen Press U TO ADJ. The history screen reflects a $0.00 amount for that item in the SUBS-AMT field [F6] view.

Online claims verification

Table 4: screen name- Substantiate patient contribution (NSCI).

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Step	Action
1	Display and partial payment amount to be verified Place the cursor under the amount in the Fee field and press [F1]. The amount to be verified is displayed as Partial Payment amount.
2	Pay and verify claim 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
3	Pend items 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

Operational Information

Verify services for Medicare Safety Net 011-43080050

On this page:

Verify services for an individual member of a Safety Net family

Print verification receipts

Change verification amount to zero

Online claims verification