Common Reasons for Denial

• The time limit for filing has expired. Claims must be filed within one year of the date of service. If an act of nature, such as a flood, fire, or there are other circumstances outside of the supplier's control, you can appeal the timely filing, by providing this explanation.

Next Step

• A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article , and Documentation Checklists prior to submitting request.

How to Avoid Future Denials

• Review the date of service prior to submitting the claim.
• Reopenings must be submitted one year from initial determination date or after one year from receipt date due to overpayment via clerical error omissions