Small and Rural Providers - JF Part B

A provider of services with less than 25 full-time employees or a physician, practitioner, facility, or supplier with less than 10 full-time equivalent employees.

This page offers links to resources for small and rural providers to assist with successful Medicare billing.

Enroll in Medicare

• Enrollment - Access information to enroll and/or make changes online using PECOS Web, Electronic Funds Transfer (EFT), Reasons for delays.
• Enrollment On Demand (EOD) - View Enrollment on Demand Tutorials for assistance with enrolling, making changes or revalidating with Medicare.
• Revalidation - View Revalidation details, tools, application submission, what happens if a provider fails to revalidate, tips and resources.

Resources for Billers

• Claim Submission - Claims can be submitted electronically or via paper on a CMS-1500 Claim Form
• Claim Submission Billing, Errors and Solutions - For assistance on claim denied, review the top claim submission errors and solutions.
• Request an Appeal - Providers have the right to appeal Medicare coverage and payment decisions, once an initial claim determination is made.
• Access Fee Schedules - A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis.
• Refunding Medicare - Review what steps to take when refunding Medicare.
• Health Percentage Shortage Area (HPSA) - Determine if you fall into a HPSA area
• Mandatory Electronic Claim Submission - Determine when you need to file a claim to Medicare.

Resources for Clinicians

• Locate Policies - Local Coverage Determinations (LCDs) - An LCD is a decision by a contractor under Medicare Part A jurisdiction respecting whether a particular item or service is covered within the states that the contractor administers Medicare on behalf of CMS.
• Telehealth - Find out more about providing telehealth to your beneficiaries.
• Preventive Services - Review and search what Preventive Services Medicare covers.
• Quality Payment Program - Information and resources to help understand how the QPP works for small, underserved, and rural providers.

Education

• View "Latest Updates" Articles - View the latest news and informational articles from Noridian and CMS.
• Sign up for Medicare Training - Explore Medicare information at your own pace, on your own time. Access resources such as web-based workshops, tutorials, Ask the Contractor Teleconferences (ACTs), Provider Outreach and Education (POE) Advisory Group (AG) meetings, and other educational material.
• Sign Up for the Noridian Email Newsletter - Receive the latest CMS and Noridian updates each week. Sign-up for the Medicare Part A Email Newsletter.
• Provider Outreach and Education Advisory Group (POEAG) Callout - Are we meeting the needs of our small and rural providers? If not this group is a great way to let us know what your specific educational needs are.

Self Service Tools

Once a provider is enrolled in Medicare, we offer a variety of tools that you can use for Self Service. Our Self Service Tools include:

• The Noridian Medicare Portal (NMP) - As a small provider, it is recommended to register for a dual role in the Noridian Medicare Portal where you can access online eligibility, claim status, single-claim remittance advices, and appeal submission and status.
• Use the Interactive Voice Response (IVR) System - To provide an efficient and more streamlined service to you as a Medicare provider, CMS and Noridian require Medicare providers to use the IVR for IVR specific information. IVR details including a flowchart and detailed IVR User Guide are available within the Contact section of this website.
• Verify Noridian Contact Information - Phone numbers for various Noridian teams (Enrollment, Contact Center, Electronic Data Interchange, and User Security) in addition to the mailing address for claims, correspondence, appeals, Freedom of Information Act requests, and Fraud referrals are provided in the Contact Us section of the website.