How to Get the Most out of Your Customer Service Contact

When calling the Provider Inquiry telephone line, please have the following information available for the Customer Service Representative (CSR) prior to your call - this enables us to respond to you in a timely manner.

• National Provider Identifier (NPI)
• Provider Transaction Access Number (PTAN)

For claim specific information the following will be required:

• The Health Insurance Claim Number (HICN) of the patient in question
• The patient's last name and first name or initial
• The date(s) of service in question

Note: Effective March 1, 2009, you will also be required to provide a third data element for authentication, the last 5 digits of your Tax Identification Number (TIN). You will only be allowed three attempts to correctly provide your NPI, PTAN, and last 5-digits of your TIN.

Our CSRs have the knowledge and expertise to respond to your questions. Where applicable they can also assist you in locating information on the Wisconsin Physicians Service (WPS) Medicare and the Centers for Medicare & Medicaid Services (CMS) Websites. These Websites have multiple resources on Medicare rules, regulations, and claim processing guidelines, and can answer many of your questions. Both Websites have a search function to help you find the information you need. By taking advantage of these resources, it may save you a phone call to our office. Please bookmark these as favorites: WPS Medicare MAC Part A homepage and CMS Website.

When a CSR determines your issue is complex, they may escalate your call to a Senior CSR. Please be prepared, the CSR will request:

• Your name
• Your NPI and PTAN
• Your telephone number (and extension)

Page Last Updated: Wednesday, 17-Feb-2010 14:07:58 CST