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Medical Review Decisions

Accessing MR Decisions

The comments from Noridian's Medical Review Examiners which provide a detailed explanation on what was used for the basis of the claim processing decision are available to suppliers within the Noridian Medicare Portal. Noridian considers this claim-specific information secure and protected health information and does not make the information publicly available outside of our portal.

Claim Processing Comments

The portal offers access to view claim processing comments if a claim had been selected for prepayment review in which Noridian requested documentation prior to making a claim decision. If the claim had a history of being reviewed for additional documentation, the portal will offer a "Noridian Comments" link in the claim header. In the event a claim was not suspended during processing, this option will not be presented.

Portal showing Noridian Comments link in the claim header.

After selecting this link, the claim processing comments will be retrieved and presented.

Noridian Comments. Claim processing comments will display here.

There may be a rare occasion where a claim's history does not have comments associated with it; however, the portal might offer the "Noridian Comments" feature. In this situation, a message will be displayed indicating comments are not available.

Last Updated Jul 20, 2016