New Functionality in Interactive Voice Response (IVR) System

Providers who call 1-888-TRIWEST (888-874-9378) now have the ability to check detailed claims information over the phone. This new functionality gives you the ability to obtain the information you need 24/7 without the assistance of a customer service representative.

Navigation

You will be prompted to enter your 10-digit National Provider Identifier (NPI) number when entering the system. If you don’t know your NPI number, you can enter your Provider Tax Identification (ID) number. From there, enter the sponsor’s Social Security Number.

Claims Information

Once you select “claims” from the menu, you will be asked if your call is regarding claims status, claims submission, none of the above or main menu.

If you select claims status:

• You will be asked to enter the 2-digit day, 2-digit month and 4-digit year of the beginning date of service for the claim.
• Enter the full amount billed on the claim, including dollar and cents. The system will look up the record and determine if there is a match or matches.

The IVR will provide information on up to five matching claims. Detailed claim and check information is given on paid and reprocessed claims. More complex claim situations are identified by the system and routed to a claims Customer Service Representative (CSR) for additional assistance.

If a claim is not found, you will receive a message that no claims were found with that specific billed amount and beginning date of service. If it was recently submitted, please allow 30 days from the date of service for processing.

Claims CSRs will still be available to assist you if the IVR has not provided the relevant information. Additional information, including an updated IVR tip sheet, will be available soon on www.triwest.com/provider.

Remember, registered users on the secure provider portal at www.triwest.com enjoy the following benefits:

• Verify patient eligibility
• Research covered benefits and check referral/authorization and medical review requirements for specific codes
• Submit referrals/authorizations online and check their status regardless of how the request was submitted
• Submit claims online and check claim status regardless of how the claim was submitted
• Download remittance advices

Register for secure access to the TriWest Web site today.