Fax Numbers

To ensure your submitted faxes are received by Noridian and processed in a timely manner, follow these five guidelines:

  1. Direct your fax to correct Noridian department
  2. Submit a fax cover sheet which includes:
    • Total number of pages
    • Noridian department name
    • Provider name
    • Provider contact information
  3. Submit a single fax transmission with all documents to support a single claim/request. There is not a system in place to consolidate multiple fax receipts to a single claim, inquiry, appeal etc.
  4. Submit a separate fax for each claim, inquiry, or response with all supporting documentation attached for that specific claim
  5. Review clarity of documents being faxed to ensure contents will not be distorted when faxed. Highlights, shading, previously faxed pages where legibility may be further diminished if re-faxed

Noridian cannot accept initial/new claim form submissions via fax.

Departmental Fax Numbers

General Inquiries
General Written Inquiries, Medicare Secondary Payer (MSP), PWK (paperwork), Redeterminations, and Written Reopenings
701-277-7852
Local Coverage Determination (LCD)
Reconsiderations and New LCD Recommendations
701-715-9553
Medical Review (MR)
Prepayment Review Documentation Requests, Medical Documentation Specifically Requested and Dialysis Waivers
701-277-7852
Medical Review (MR)
Post-Payment Review Documentation Requests
701-277-6977
Medical Review (MR)
RSNAT Prior Authorization Request
701-433-3024
701-277-7868
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