Fax Numbers - JA DME

Review the following information prior to sending a fax to Noridian.

1. Direct your fax to correct Noridian DME department
2. Submit a fax cover sheet which includes total number of pages, Noridian DME department name, supplier name, and contact information
3. Submit all documents in one fax transmission as there is not a system in place to consolidate multiple responses to a single claim, inquiry, appeal etc
4. Submit a separate fax for each claim, inquiry, or response with all supporting documentation attached for that specific claim
5. Review clarity of documents being faxed to ensure contents will not be distorted when faxed (highlights, shading, previously faxed pages where readability may be further diminished if re-faxed)

View departmental fax numbers below.

• Adjudication - Additional Documentation Request (ADR) Letter: 701-277-7880
• Administrative Simplification Compliance Act (ASCA) - Waiver request/documentation: 701-277-7882
• Appeals - Reopenings and Redeterminations: 701-277-2425
• Congressional Inquiries: 701-277-7884
• Freedom of Information Act (FOIA): 701-277-7884
• LCD: New LCD Request Process: 701-277-7888 Attn: DME New LCD Request
• LCD Reconsideration Request: 701-277-7888 Attn: DME LCD Reconsideration Administrator
• Medical Review - ADMC Requests/Documentation: 701-277-7890
• Medical Review - Medical Documentation: 701-277-2426
• Medical Review - Prior Authorization Requests (PAR): 701-277-7891
• Medicare Secondary Payer (MSP) Inquiries and Refunds: 701-277-7892
• Provider Outreach and Education (POE): 701-433-5957
• Recoupment - Immediate Offsets: 701-277-2427
• Recoupment - Recovery Auditor - Recovery Auditor Offset: 701-277-7896
• Recoupment - Refunds to Medicare and Extended Repayment Schedule (ERS): 701-277-2427
• Recovery Auditor Redeterminations: 701-277-2425