Page 80 - R2P Front Desk Manual v1

How to Verify Medicare

Medicare benefits are verified via the interactive voice response (IVR) system. You will not need
to speak to a representative unless you have additional questions.

1. Call 877-235-8073
2. Verifying Medicare Part B
3. State in which services are rendered: Maryland
4. Services rendered in Prince George’s or Montgomery County? No
5. You want Eligibility information
6. NPI #: 1306251434
7. PTAN: (each clinic location has a different PTAN)
8. Last 5 digits of TIN (tax ID #): 46543
9. Eligibility
10. Speak the patient’s 11-character Medicare number (does not use letters S, L, O, I, B, Z)
11. Speak the patient’s first and last name and their date of birth
12. Provide a date of service: Today (should always be the current date, not previous/future)
13. Record all information as a Chart Note in the patient’s WebPT case.
14. IMPORTANT! Add any dollar amount used for the patient’s PT cap limit to their
Insurance section prior to their first appointment.

a. This dollar amount will automatically update as charges are input during the
patient’s treatment. If the patient approaches their cap, it will trigger a notification
for the PT to apply the KX Modifier for continued treatment.
■ Note: If Medicare is the secondary insurance, the cap for PT does not
apply (per Stacy with WebPT).
15. Use the appropriate clinic location’s Medicare (LOCATION) carrier when inputting the
patient’s insurance information.
a. If a patient will be seen in multiple locations, then a new case must be created
and the appropriate clinic’s Medicare carrier attached.

Last Update: 7/9/19