Verify HMO/MCO Status on the Noridian Medicare Portal (NMP) to Ensure Billing to Correct Payor

A dedicated tab can be found in the NMP for Health Maintenance Organization (HMO) and Managed Care Organization (MCO) information.

Obtain the following information regarding beneficiaries by selecting the Eligibility tab on the NMP.

  • Insurer name
  • Policy number
  • Effective and termination dates
  • Plan type
  • Bill option code
  • Plan address
  • Plan phone number

Utilizing the information found here, avoid denials by billing the correct payor the first time. Suppliers may learn more in the Inquiry Guide on the NMP webpage.

            Last Updated Tue, 13 Apr 2021 17:28:13 +0000