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Medical Eligibility Verification System

South Dakota residents who are eligible for state-sponsored medical benefits (Title XIX or CHIP) are issued a Medical Benefits Card. This card must be presented and used to verify a patient's eligibility through the Medical Eligibility Verification System (MEVS) each time the patient receives services.

The MEVS offers numerous benefits to South Dakota healthcare providers:

  • Access to the "live" medical eligibility file
  • Verification of eligibility for each person before a service is provided
  • Review of the recipient's record for program restrictions
  • Printable receipt of the eligibility information for the patient's record
  • Eligibility verification available 24 hours a day, seven days a week
  • MEVS Fact Sheet

The MEVS electronic verification system gives you immediate access to the patient's eligibility status for the current date of service or a previous date of service. The process requires only a swipe of the patient's Medical Benefits Card through a point-of-service terminal or a few key strokes on a computer. If the response shows the patient is not eligible for the specified date of service, you know immediately that the patient is liable for payment of any services provided.

The MEVS system may also be used to access data from other payer sources such as other state's Medical Assistance programs and from many private health insurance companies.

Emdeon, our contracted information provider, offers three options to verify eligibility information. The three options are:

  • Point-of-service terminal (swipe device similar to credit card verification) which may be purchased or leased
  • Personal computer software
  • Secure Web-based site

All three options provide prompt response times, printable receipts and can verify eligibility status for prior dates of service. There is a nominal fee for each verification obtained through Emdeon.

The alternative to electronic verification is to use the South Dakota Medical Assistance telephone audio response unit (ARU) by calling 1-800-452-7691. Each call takes approximately one minute to complete and this system is limited to current eligibility verification only.

  • New customers can contact Emdeon at 1-866-369-8805.
  • Existing customers can contact Emdeon at 1-877-469-3263.
  • Website: www.emdeon.com