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devices for women who are not otherwise eligible for MA. The EBT card is issued to MA recipients who receive cash assistance and/or food stamps as well as medical services, if eligible. EVS will also provide details on the recipient's third-party resources and managed care plan when applicable.

The recipient is showing eligible for Healthcare Benefit package (HCB) 15, what services are they covered for?HCB 15 is SelectPlan for Women. What happens if a recipient loses his/her ID card?When a Pennsylvania ACCESS card is lost or stolen, the recipient should contact his/her County Assistance Office (CAO) caseworker to request a replacement card. Instructions on how to register and use the PROMISe™ Internet can be found in the PROMISe™ Internet User Manual. 5. caseworker to request a replacement card. The eligibility request format is called the HIPAA 270 Health Care Eligibility Benefit Inquiry format (also known as 270 Eligibility Inquiry). The MHX category is only used for tracking mental health service encounter claims for County Mental Health Funded Base Programs. It is important to verify and submit accurate recipient information when checking eligibility via the EVS. All Medical Assistance (MA) providers should check the PROMIS. The PROMISe™ Eligibility Verification System enables a provider to determine a Medical Assistance recipient’s eligibility as well as their scope of coverage. This is pursuant to the 18 visit limit, during the July 1 through June 30 state fiscal year service period. If, however, you use the recipient's social security number and date of birth, you may receive an eligible response because both of these elements are most likely accurate.

For example, if you perform an inquiry using the 10-digit recipient ID number and the two-digit card issue number, and either one of those data elements is incorrect (most likely the card issue number, as you must use the most current card issue number), you will receive an ineligible response. EVS should be accessed on the date the service is provided since the recipient's eligibility is subject to change. The Medicaid program of Pennsylvania follows certain requirements that enrollees must meet. Providers and other approved agencies that submit electronic requests in the 270 format will receive an EVS response with eligibility information in the 271 format. The recipient is not MA eligible if they only have EPOMS.

Providers can submit individual web interactive EVS requests via the, Batch EVS requests need to be submitted utilizing the ANSI X12 v5010 270/271 transaction sets. Do not assume that a participant is eligible for Medical Assistance because he/she has an ACCESS or CHC health plan ID card.

Providers can access EVS through the Both formats may also be referenced by the 3-digit transaction number, 270 and 271. The PROMISe™ Eligibility Verification System (EVS) enables you to determine a Medical Assistance recipient’s eligibility as well as their scope of coverage. It is vital that you verify the recipient's eligibility through the Eligibility Verification System (EVS) each time the recipient is seen. %%EOF Provider Electronic Solutions Software is available free-of-charge by downloading from the OMAP PROMISe™ … If those methods are not available, they can access the EVS through the Automated Voice Response System by calling 1-800-766-5387 and entering the recipient's social security number and date of birth.

A replacement card should be received in a maximum of seven days. h��Ymo�8�+�K��Z|Y���h{�&�Y@�5֥�%�a�����gHɖŕ���p0��9$��3� A recipient’s eligibility is subject to change; Proudly founded in 1681 as a place of tolerance and freedom. For example, if you perform an inquiry using the 10-digit recipient ID number and the two-digit card issue number, and either one of those data elements is incorrect (most likely the card issue number, as you must use the most current card issue number), you will receive an ineligible response. Recipient information is listed on the front of the card and includes the full name of the recipient, a six-digit bank code number followed by a 10-digit recipient number, then a two-digit card issue number, and a bank verification number. You may be trying to access this site from a secured browser on the server.

Welcome to the Pennsylvania Licensing System (PALS) PALS can help you apply for, renew, and check your professional license. Both formats may also be referenced by the 3-digit transaction number, 270 and 271. 4. 102 0 obj <>/Filter/FlateDecode/ID[<46AB8D3C391F27418DD69ED7F542B31C><34C31C85A0C9324FA6B9C9FEFD3A72C5>]/Index[79 69]/Info 78 0 R/Length 115/Prev 372090/Root 80 0 R/Size 148/Type/XRef/W[1 3 1]>>stream EVS will accept and return the standardized electronic transaction formats for eligibility requests and responses as mandated by the Health Insurance Portability and Accountability Act (HIPAA). Again, it is often easier for us to research your specific problem if you write us. HCB 15 is SelectPlan for Women. Recipient information is listed on the front of the card and includes the full name of the recipient, a 10-digit recipient number, and a 2-digit card issue number. EVS will return the response "The ACCESS card is invalid". Pennsylvania Medical Assistance (MA) PROMISe™ Eligibility Verification System (EVS), Develop a skilled workforce that meets the needs of Pennsylvania's business community, Provide universal access to high-quality early childhood education, Provide high-quality supports and protections to vulnerable Pennsylvanians. This is pursuant to the 18 visit limit, during the July 1 through June 30 state fiscal year service period. A participant’s eligibility is subject to Pennsylvania Medical Assistance (MA) PROMISe™ Eligibility Verification System (EVS) Providers can submit individual web interactive EVS requests via the PROMISe™ Internet. Providers and other approved agencies that submit electronic requests in the 270 format will receive an EVS response with eligibility information in the 271 format. The Eligibility Verification System (EVS) has been enhanced to inform providers when a recipient has exceeded the 18 visit, limit. If a card is needed immediately, an interim paper card can be issued by the CAO. If not, EVS indicates the number of countable office visits, clinic and home visits remaining within the scope of benefits for adult MA and adult GA recipients. The interim card contains the same Recipient Number and Card Issue Number as the previous ACCESS card.

The Electronic Benefits Transfer (EBT) card can now have two faces, both of which are valid. Recipients who are eligible for medical benefits only will receive the yellow ACCESS card. If not, EVS indicates the number of countable office visits, clinic and home visits remaining within the scope of benefits for adult MA and adult GA recipients. %PDF-1.5 %���� The name, age, and gender of … h�b```a``������0�A���2�@�������aT\��'��)F���p V ��3���(���2�=���� � It is vital that you verify the recipient's eligibility through the Eligibility Verification System (EVS) each time the recipient is seen. The purpose of EVS is to provide the most current information available regarding a recipient's MA eligibility and scope of coverage.

EVS will provide timely validation of the number of countable visits remaining based on actual claims paid at the time of the inquiry. Recipients who are eligible for medical benefits only will receive the yellow ACCESS card.

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