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.

Required Information

  • National Provider Identifier (NPI) and
  • Provider Transaction Access Number (PTAN)
  • Last 5 digits of your Tax Identification Number (TIN)

Note: You will only be allowed three attempts to correctly provide your NPI, PTAN, and last 5 digits of your TIN.

Other Information

  • The name of the office - This must be specific to the PTAN reported
  • The Health Insurance Claim Number (HICN) of the patient in question
  • The patient's name as it appears on the Medicare card
  • The date of service in question
  • Any remark codes and descriptions from the Standard Paper Remittance (SPR) for the claim in question
  • Your question

Our CSRs have the knowledge and expertise to respond to your questions and 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.

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

  • Your name
  • The name of the doctor or facility
  • PTAN, NPI, and TIN
  • Your telephone number (and extension)

Page Last Updated: Wednesday, 14-Dec-2011 18:03:02 CST