New Provider New Biller - JE Part B

This page is designed for those that are new to Medicare as a provider or biller, someone who has been tasked with undertaking new roles within Medicare programs, or those looking for short videos to assist with their training program.

Getting to Know CMS and Noridian

CMS Internet Only Manuals - CMS guidance on day-to-day operation instructions, policies, and procedures that are based on statutes, and regulations guidelines

Latest Updates - Weekly updates with recent changes and updates from CMS and Noridian

Noridian YouTube Tutorials - Tutorials created for Part A and Part B to help understand single aspects of a topic

Noridian Contact Information - Noridian hours of availability, email addresses, fax numbers, mailing addresses, as well as other points of contact

Noridian Email List Sign-Up - Sign up for our weekly listserv to keep up-to-date on current Noridian and CMS topics

Medicare Learning Network - Educational documentation for providers on CMS programs, policies, and initiatives

CMS Transmittals - New or changed policies or procedures that will be incorporated in the CMS Online Manual System

Understanding Medicare Self Service Tools

Noridian Medicare Portal User Manual - User Guide with step-by-step instructions on how to complete each task available in the portal. This page also includes a link to the portal and explanation of the roles available in the portal.

Noridian Medicare Portal Log-in - Log in page for the Noridian Medicare Portal

Interactive Voice Response - Access features of the IVR such as availability, tips, touch tone features for entering letters, and authentication elements

CMS Internet Only Manual (IOM), Publication 100-09, Medicare Administrative Contractor (MAC) Beneficiary and Provider Communications Manual, Chapter 6 - Medicare guidelines for usage of the self-service tools

Noridian Medicare Chatbot - To help locate resources or information located on our Noridian Medicare, available in the lower right corner of any page

Claim Submission

Claims - Instructions on how to complete each Item on the CMS-1500 claim form, claims submission billing errors and solutions, Medically Unlikely Edits (MUE), and many more helpful pages to assist in submitting claims correctly

Claim Form Tutorial - Claim form tutorial that allows users to hover over each item of the claim form to determine what information should be in this field

Denial Code Resolution Tool - Description of common denials and how to fix them

Timely Filing - Information on filing claims on time

Electronic Data Interchange (EDI) - Information and assistance on submitting electronic claims

Remittance Advice (RA) - Review important information about remittance advices

X12 Claim Adjustment Reason Codes - These codes describe why a claim or service line was paid differently than it was billed. Did you receive a code such as: PR32 or CO286? If so, read about Claim Adjustment Group Codes.

X12 Remittance Advice Remark Codes - These codes provide additional explanation for an adjustment already described by a Claim Adjustment Reason Code (CARC) or convey information about remittance processing

Appeals

Forms - Paper forms to submit for the five levels of appeals

Appeals Decision Tree - Question and answer format to help determine if an appeal is the right step

Reopenings Versus Redetermination - Information located on this page will help determine a reopening or redetermination is needed

Five Levels of Appeals - Information and resources on each of the five levels of appeals

Timeliness Calculators - Calculator to assist in determining what date the appeal must be received by Noridian to be considered timely

Documentation Requirements - Informational page to assist in determining what documentation to submit with an appeal. Includes information for specific requirements for specialty fields and topic documentation requirements.

Elements of a Redetermination Letter - This page provides a summary of each section of a Redetermination letter to help determine next steps