Tools - JF Part A

340B Drug Program Reimbursement Calculator - Used to determine the reimbursement amount of a drug purchased under the 340B Drug Program.

Acronyms and Glossary - View Medicare acronyms of common terminology. Not all-inclusive

Additional Documentation Request (ADR) Timeline Calculator - Calculate date Noridian must receive requested documentation

Administrative Law Judge (ALJ) Timeliness Calculator - Calculate ALJ submission deadline

Advance Beneficiary Notice of Noncoverage (ABN) Tutorial - Hover over form fields to identify details required for each

Ambulance Zip Code Definition Lookup - Use this tool to determine if the zip code being billed is urban, rural or super rural

Appeals Decision Tree - Determine if a claim appeal may be requested

Appointment of Representative (AOR) Tutorial - Hover over form fields to identify details required for each

Claim Submission Timelines Calculator - Calculate claim submission deadline

Documentation Checklists - View checklists to help identify records not routinely submitted by providers but must be available upon request

Education on Demand Tutorials - Access self-paced educational tutorials based on Noridian hosted webinars

End Stage Renal Disease (ESRD) 30 Month Coordination Calculator - Calculate 30 month coordination period prior to Medicare becoming primary insurance

Extended Repayment Schedule (ERS) Decision Tree - Provides a listing of the documentation needed with an ERS application depending on the length of the loan being requested

Forms - View and/or access most commonly used Medicare forms, form instructions, checklists, and coversheets

Inpatient PPS Billing for Cost Outlier Decision Tree - This tool was developed based on scenarios encountered by the Noridian Provider Contact Center

Interactive Voice Response (IVR) Conversion Tool - Determine touch-tone number sequence to enter in IVR

Medically Unlikely Edit (MUE) Lookup Tool - Helps to determine the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service

Medicare Secondary Payer (MSP) Decision Tree - Determine if Medicare is primary or secondary payer

MSP Payment Calculator - Providers may enter specific amounts from the primary insurance company's Explanation of Benefits in addition to their billed amount to determine Medicare's payment (line-level, not full claim billed amount)

NMP vs. IVR Self Service Elements Comparison - Guidance on accessing details via the Noridian Medicare Portal and/or the Interactive Voice Response

Noridian Medicare Portal (NMP) - Access web-based portal to check claim status, verify eligibility, review single claim remittance advices, submit Redeterminations request, upload supporting appeal documentation and check appeal status

OPD Prior Authorization UTN Calculator - Calculate the 120-day timeline from date of decision of OPD Prior Authorization request.

Overpayment Interest Calculators - These calculators are commonly used to determine how much interest have been accrued on an unpaid overpayment

Prior Authorization Look Up Tool - Determines which HCPCS codes require a Prior Authorization

Provider Enrollment Application Status Search - This search allows providers and suppliers to follow the application progress. Enter an Application/Reference Number or Web Tracking ID into its search field and select "View Application Status"

Provider Enrollment Corrective Action Plan (CAP), Reconsideration, and Rebuttal Decision Tree - This tool will assist the user in submitting a Provider Enrollment reconsideration request, corrective action plan or rebuttal.

Provider Enrollment on Demand Tutorials - Access self-paced application tutorials to assist in the application completion

Quick Reference Billing Guide - View compilation of commonly used coding and billing processes

Reason Code Guidance - View common claim submission error codes, descriptions of issues and potential solutions

Reconsideration Timeliness Calculator - Calculate Reconsideration submission deadline

Recovery Auditor Determination Decision Tree - Determine correct action to Recovery Auditor claim review

Recovery Auditor Timeliness Calculator - Calculate time frames for Recovery Auditor activities

Redetermination/Reopening Form Tutorial - Hover over form fields to identify details required for each

Redetermination Timeliness Calculator - Calculate Redetermination submission deadline

Reopening Timeliness Calculator - Calculate Reopening submission deadline

Site Map - View listing of primary and secondary website contents. Help and Contact information also available

Web Tour - High level overview of website content layout and design