Self Service Technology Use by Suppliers Required by CMS

CMS requires all Medicare Administrative Contractors (MACs) to refer providers and suppliers to use available self-service technology when inquiring about information that can be obtained through a self-service option when calling the MAC Call Centers. The Customer Service Representatives (CSRs) will instruct providers and suppliers to use the MACs portal or Interactive Voice Response (IVR) System to obtain the information in question.

The Noridian Medicare Portal (NMP) offers a wide variety of claim, remittance and beneficiary information that can be obtained without having to call the call center. View the End User Manual to see all the information available through NMP and step-by-step instructions for obtaining this information. If you are not registered for the NMP, the Registration Guide will assist in the registration process.

Noridian requires the NMP to be used for the following inquires:

NMP Function Description
Eligibility View beneficiary Medicare eligibility: Part A, Part B, Managed Care Organization (MCO) and Health Maintenance Organization (HMO), Medicare Secondary Payer (MSP), Home Health, Hospice, End Stage Renal Disease (ESRD)
Claim Status View status of claims, Medical Review comments and initiate a Self-Service Reopening or Redetermination on finalized claims
Additional Documentation Request (ADR) If an ADR was sent to supplier and claim is pending, suppliers may view letter and submit supporting documentation
Financials View pending and finalized check information
Overpayments View a summary of what claim caused the overpayment and how it is being satisfied
Appeals Submit an appeal and view the status of previously submitted appeals
Remittance Advice View a claim specific remittance advice
Same or Similar View same or similar equipment provided to beneficiary
PMD Prior Authorization Status View status of Power Mobility Device (PMD) Prior Authorization Request (PAR) status

 

The specific services for which Noridian requires providers to use the IVR include:

IVR Function Description
Eligibility Obtain Beneficiary's Medicare eligibility: Part A, Part B, Managed Care Organization (MCO) and Health Maintenance Organization (HMO), Medicare Secondary Payer (MSP) details, Home Health, Hospice, Inpatient Stay Dates, and Date of Death. 
Claim Status Receive status of claim and overlapping claim information
Financial Receive Pending and Finalized check information, a financial summary, patient account numbers, date or service and overpayment amounts. A payment floor summary and pricing information is also available
Appeal Status Inquire on the status of a Reopening or Redetermination.
Full Remittance Advices Request a duplicate Remittance Advice
Same or Similar Receive details about same or similar equipment provided to beneficiary. This includes a same to same A-L-V lookup.
PMD PAR Details Check the status of Power Mobility Device (PMD) Prior Authorization Request (PAR)

 

The IVR offers both voice and touchtone input options. The IVR Conversion Tool, assists callers in determining the touch-tone data-entry when avoiding the voice recognition option is preferred. The IVR Guide gives step-by-step instructions for using the IVR and provides all information available through the IVR.

The CSRs are available to answer your questions and assist you with learning to use these tools. Ask a CSR today to obtain a better understanding of the Portal and IVR.

 

Last Updated Aug 15, 2018