Review the following information prior to sending a fax to Noridian.
- Direct your fax to correct Noridian DME department
- Submit a fax cover sheet which includes total number of pages, Noridian DME department name, supplier name, and contact information
- 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
- Submit a separate fax for each claim, inquiry, or response with all supporting documentation attached for that specific claim
- 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)
Departmental Fax Numbers
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