Enrollment Application Status Search - JF Part B

Application Complete/Approved

Welcome to Medicare. Provider is now able to bill for the services rendered.

• Next step: Register with EDI. (Does not apply to group members)
  • View Total Enrollment: EDI Enrollment webpage for instructions

Application fee requested

Application fee must be paid before it can continue processing

• If not paid, application will reject
• View Application Fee webpage for details

Application not found

Application/tracking number searched is not valid

• Avoid extra spacing before/after application/tracking number, ensure all numbers are entered/correct, and allow adequate processing time before checking status. If too soon, try again in five business days

• The application has been received by Medicare and will be logged into our internal system for processing to begin

Clock Stoppage

For a list of the clock stoppage reasons, please refer to the CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 10, Section 10.5 C.1 Timeliness and Accuracy Standards for processing clarification.

Denied

Application submitted did not meet Medicare standards.

• Possible reasons for denial: Provider specialty on application is not able to enroll in Medicare, fingerprints not completed as requested, provider is opted out of Medicare, is not able to fully enroll, or provider is revoked

Notification letter will provide next steps.

• If application resubmission is necessary, provider must wait a full 60 days before resubmitting.
• If resubmitted before the 60 days, application will deny again

Entering into PECOS

Application is nearly complete

• Enrollment will populate in PECOS shortly
• Provider must receive notification letter from Noridian to start billing

Entering into Standard System

Enrollment is being entered into Medicare system

Finalizing Application/ Preparing your approval letter

Last step in application process

• Notification letter is being created and will be emailed or faxed to contact included on application
  • If unsuccessful, Noridian will mail it to contact address in application

Indexing Application

Noridian has received application and is in process of entering it in our internal system

• Application status will be updated when it is assigned to a Noridian representative for processing

Initially Reviewing

Application has been assigned to a Noridian representative and is currently under review

• Development request may be sent your (provider) way
  • Will be sent via to email or faxed to contact included on application
    • If unsuccessful, Noridian will mail information to contact address in application

Noridian has identified this application as a duplicate of another in process

Another application has been submitted with same information

• This application will be returned as not needed

Pending State Contact

Noridian has completed initial application review and have sent it for state and CMS review

• This can take several months. It is recommended that provider contacts the state at phone number provided in Noridian Recommendation letter
• Once all state requirements have been met and CMS has approved, Noridian will finish processing application

Reject

Application has been rejected

• Reasons/Example of rejections: Additional requested information was not sent in, was sent in but was incomplete, or was sent in after the 30-day time frame; application fee was requested but was not sent in
  • New application must be submitted to complete request on application
• Do not agree with rejection? Call Enrollment Contact Center for further reviewal

Resubmit through PECOS

Corrections for submitted PECOS application have been requested

• Make corrections via PECOS

Returned

Application returned

• Possible reasons for return: Applicable unnecessary since information is already on file; duplicate application (already an application submitted); unsolicited revalidation (enrollment has not been requested to revalidate at this time); appeal period not expired; bar period not expired; belongs to another carrier; future effective date (effective date is over 60 days in advance) application was requested back by application contact; wrong application submitted

Revocation

Enrollment in question has been revoked

• Read letter carefully.
• Letter will provide next steps. May be worded in one of two ways.

1. A Corrective Action Plan (CAP) is needed. For more information regarding a CAP, please visit the Provider Enrollment Appeals Process website.
2. A Reconsideration (Appeal) is needed. For more information regarding an Appeal, please visit the Provider Enrollment Appeals Process website.

• Keep in mind that a CAP and an Appeal are independent from one another and in certain cases cannot be used congruently

We are completing the enrollment process and forwarding the information to another department who will complete the approval letter

• Noridian has received Tie-in letter, application will move to next phase
• Once enrollment has been entered into Medicare system, another Noridian department will complete notification letter

We have requested additional information from you

• Provider must submit additional information to Noridian to ensure application can continue processing
  • If information is not received within 30 calendar days, application will be rejected
    • Provider may need to check his/her spam and junk mail

Your Application has been approved for additional corrections

• Requested revisions have been received.
• Noridian representative working on application will review submitted information. If missing information, application may be rejected