How do I document verification of recipient eligibility?

You can obtain a call reference number through the AVRS. If you use the Web Portal you may choose to save a copy of the screen print or print out a hardcopy. If you use a MEVS vendor you will receive hard copy when you verify eligibility that you can save.

To show proof that we verified eligibility, we use a spreadsheet with recipient name, Medicaid number, date checked and comment box. Is this enough to show or document verification of eligibility? We verify eligibility using the web portal.

Many providers print out or save a screen shot of the page when they look up the eligibility and put it with the recipient’s file. If there is ever a discrepancy at a later time with the recipient’s eligibility it will show what the provider saw at the time the provider checked the eligibility

It is the provider’s responsibility to verify a patient’s Medicaid eligibility prior to providing any Medicaid reimbursable services.” If a recipient is not eligible for the month of September until the 15th of the month (and then eligibility is retroactive for the entire month), but services were provided earlier in September… will those services be billable once the recipient becomes eligible for the month?

Yes, once the recipient has eligibility for the date of service. Keep in mind that if you provide services for a person who is not eligible, you should not expect Medicaid payment. The recipient must be informed and agree to receive services that may not be covered by Medicaid. See Page “1-7” in Chapter 1 of the Florida Medicaid Provider General Handbook. All Medicaid handbooks, fee schedules, forms, provider notices, and other important Medicaid information are available on the Medicaid fiscal agent’s Web Portal at: http://mymedicaid-florida.com/

Will the system’s speed ever be improved? We have 60+ individuals to verify eligibility on. This process currently takes hours and hours to complete because the system response is so slow.

You may want to look into submitting batch transmissions. These can be done on the web portal or with most of the eligibility vendors. You can contact the fiscal agent for assistance with the web portal at www.mymedicaid-florida.com.