Noridian CERT-Related Communications

View CERT-related communications suppliers may receive from Noridian. Below is a listing of the most common types of communication that suppliers will receive from Noridian, primarily by fax. Faxes are sent to the supplier point of contact listed on the CERT Provider website. If changes to this contact information are required, view the CERT Provider website for instructions.

  • MRS Call fax: A MRS Call is initiated by CERT in instances when an additional documentation request was issued, a response was received, but additional medical documentation is required to complete a medical review decision. The MRS Call places the claim review on hold and the physician associated with the claim is granted 10 days to respond. As a courtesy, Noridian may send a fax to the supplier containing the reviewer comments indicating that a response has not been received from the physician.
  • Tech Stop fax: A Tech Stop is initiated by CERT in instances when an additional documentation request was issued, a response was received, but additional documentation is required to complete a medical review decision. The Tech Stop places the claim review on hold and the supplier associated with the claim is granted 15 days to respond. As a courtesy, Noridian may send a fax to the supplier containing the reviewer comments indicating that a response has not been received.
  • CERT Medical Review Comment Fax: As a courtesy, Noridian may send a fax to the supplier containing the reviewer comments for CERT denials which may be remediable with simple record corrections. The purpose of this communication is to assist the suppliers in providing the correct information, as well as to reduce the CERT error rate. Note: Not all denials will receive this fax.
  • Change in Status fax: A Change in Status is issued by CERT when a claim decision is reversed or changed. Noridian will fax a supplier notification of CERT claims that have been issued a Change in Status. This is notification only and there is no supplier action required upon receipt of these faxes.

Questions regarding CERT can be directed to the Noridian CERT Coordinator by phone at 701-433-3090 or by email at jadmecert@noridian.com.

 

Last Updated Oct 23, 2018