Do you use your local MAC to see last visit

LuckyLily

Networker
Local Chapter Officer
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90
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I am wondering if anyone uses there local MAC to look up patients to see when they had there IPPE or Initial/Subsequent Wellness Visit? In the MLN booklet put out by Medicare it says you can check AWV eligibility information through HIPAA Eligibility Transaction System(HETS) or through the provider call center Interactive Voice Responses (IVRs).

Does anyone have experience doing this and do you feel as if it is effective? I'm trying to find a better way to make sure we are capturing the correct level of service when we do our HCCs. Noridian is our carrier.

Thank you.
 

Pathos

Expert
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448
Location
Beaverton OR
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Yes, but...

Hi LuckyLily,

I ran into a similar problem with looking up IPPE/AWVs when I worked at a providers office.
The main issue I found was that while you definitely can lookup up some Medicare members through Noridian (my local MAC as well), you would not be able to find any Part C beneficiaries. To my knowledge the lookup tool only works for Medicare Part A & B only, but does work great with those members.

You might have to reach out to the other Health Plans (United Health Care, BlueCross, Kaiser, Providence, etc) and see if you can get access to their look up tool, if they have that feature.

Good luck!
 
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