Review Eligibility Details

The Eligibility Response Details page contains the information that was received from NY Medicaid. The amount of information contained in the response is dependent on the specific plan in which the client is enrolled.

The information presented is divided into sections. Any or all of these sections may be blank depending upon the level of information supplied by NY Medicaid.

Client Information - Includes the Client ID, Client Name, Address, Date of Birth The birth date of the individual, e.g., 04/15/1995. and Gender to assist in ensuring Eligibility was requested for the proper individual. Additional information displayed includes SSN, Anniversary Date, Plan Date and Recertification month.

Medicaid Eligibility Information - The client's status with NY Medicaid for the Date of Service submitted along is written out followed by the Co-pay Remaining. Covered Services and Non-Covered Services are listed in side-by-side tables. Refer to the MEVS manual for guidance on interpreting service type information.

Medicare Information - The Payer Name and Medicare Identifier will be returned.

Third Party Insurance - Up to nine third party insurance policies can be returned. For each policy, the following will be returned (if available): Other Payer Name, Carrier Code, Other Payer Address, Phone Number, Policy Number and Group Number.

Once you have reviewed the information displayed on the page, you may click the Close button which sets the status of the response to Viewed, closes the Details page and returns to the Eligibility Activity Worklist.