Email Submission Guidelines for Audit and Reimbursement Requests - JE Part A
Email Submission Guidelines for Audit and Reimbursement Requests
Providers must follow the email submission requirements outlined below when sending requests to our Audit and Reimbursement team. Proper formatting ensures timely and accurate processing.
| Submission Type | Email Address | Subject Format | Example |
|---|---|---|---|
| 2nd Interim Rate Review (IRR) | noridianratereviews@noridian.com | PTAN FYE: Provider Type* 2nd Rate Review - Provider Name | 000000 12/31/2025: PPS 2nd Rate Review - ABC Hospital |
| 2nd PIP | noridianratereviews@noridian.com | PTAN FYE: 2nd PIP Type of Information** | 000000 12/31/2025: 2nd PIP Questionnaire |
| B-1 Stats | B1stats@noridian.com | B-1 Stats Change Request - PTAN FYE | B-1 Stats Change Request - 123456 12/31/2025 |
| End Stage Renal Disease (ESRD) Low Volume Attestation | esrdlowvolumeattesations@noridian.com |
Individual provider request: PTAN, ESRD Low Volume Attestations YYYY (year of attestation) Multiple provider requests: Main Provider name, ESRD Low Volume Attestations YYYY (year of attestation), Jurisdiction |
Individual provider requests: 122345 ESRD Low Volume Attestations 2026 Multiple provider requests: ABC Hospital ESRD Low Volume Attestations 2026, JE |
| Graduate Medical Education (GME) Affiliation Agreements | GMEAffiliationAgreements@noridian.com | GME Affiliation Agreement - PTAN, FYE | GME Affiliation Agreement - 123456, 12/31/2025 |
| Initial Periodic Interim Payment (PIP) | noridianratereviews@noridian.com | PTAN FYE: Initial PIP Type of Information** | 000000 12/31/2025: Initial PIP Cost Report |
| Inpatient Rehabilitation Facility (IRF) 60% Review | IRF-60-Percent-Review@noridian.com | PTAN, FYE, IRF 60% | 00000, 12/31/2025, IRF 60% |
| Provider Based Determination | providerbasedattesations@noridian.com | PTAN Provider Based Attestation | 000000 Provider Based Attestation |
| Provider Statistical and Reimbursement (PS&R) | PSR@noridian.com | PS & R Request, PTAN FYE, PS&R | PS & R Request, 000000, 12/31/2025, PS&R |
| Wage Index | JE-WageIndex@noridian.com | PTAN, FYE, Wage Index | 000000, 12/31/2025, Wage Index |
* Provider Type
| Provider Type | Abbreviation (Use in Subject Line) |
|---|---|
| Prospective Payment System | PPS |
| Critical Access Hospital | CAH |
| Federally Qualified Health Center | FQHC |
| PPS Rural Health Clinic | PPS RHC |
| Tax Equity and Fiscal Responsibility Act | TEFRA |
| Skilled Nursing Facility | SNF |
| Long-Term Care Hospital | LTCH |
** Type of Information (PIP): Choose one of the defined options (Questionnaire, Model, Cost Report, Other)
Common Formatting Tips
- PTAN: Use the six-digit provider number (e.g., 000000)
- FYE: Enter the fiscal year end date in MM/DD/YYYY format (e.g., 12/31/2025)
- Ensure spacing and punctuation match the examples provided for consistency
Last Updated Mar 30 , 2026
