Article Detail - JA DME
NMP and/or IVR Use Required for Eligibility Inquiries - Effective February 18, 2019
Effective February 18, 2019, Noridian will require suppliers to use the Noridian Medicare Portal (NMP) and/or the Interactive Voice Response (IVR) for all eligibility inquiries. Until then, Customer Service Representatives (CSRs) will educate callers on these tools.
To access specifics about each, select the webpage links below.
NMP: Provides Part A and B effective and termination dates, deductible remaining, ineligible period (due to classified as unlawfully present, deported or incarcerated), beneficiary address, Managed Care Organization (MCO) and Health Maintenance Organization (HMO), Medicare Secondary Payer (MSP), Home Health Episode History (HHEH), Hospice, Hospital periods, Skilled Nursing Facility (SNF) periods
- View the Self Service Tools section of DME On Demands to get a better understanding of the options available
- IVR: Provides effective and termination dates, deductible information, Managed Care (HMO), MSP, home health, hospice, SNF periods, and date of death
The CMS Internet Only Manual (IOM), Publication 100-09, Chapter 6, Section 50.1 mandates that all providers first access inquiries through self-service technology, "...Providers shall be required to use the IVR system to access claim status and beneficiary eligibility information. CSRs shall refer providers back to the IVR system if they have questions about claims status or eligibility that can be handled by the IVR system.... Each MAC has the discretion to also require that providers use the Internet-based provider portal for claim status and eligibility inquiries if the portal has these functionalities."
This process change will allow Noridian to meet CMS requirements and our CSRs to assist callers with more complex inquiries which cannot be answered through these self-service tools.
Last Updated Wed, 05 Feb 2020 16:18:44 +0000