Provider Responsibilities When Using Third Parties

Noridian has received an increase of inquiries from third party billers and outsourced companies representing providers. Many of these companies call throughout the day, asking questions required to be answered via self-service tools, or are available through your practice’s remittance advice or office staff. Examples of the frequently asked questions include, Provider’s mailing address, electronic submitter id, claim number, Medicare timely filing, to name a few. Often, the individuals call multiple times a day asking the same questions through each interaction.

The Centers for Medicare and Medicaid Services (CMS) requires providers utilize self-service tools in the CMS Internet Only Manual (IOM), Publication 100-09, Medicare Administrative Contractor (MAC) Beneficiary and Provider Communications Manual, Chapter 6, Section 50.1. These self-service tools include the Noridian Medicare Portal (NMP), Interactive Voice Response (IVR) system, provider remittance advice, and Medicare public websites.

To best protect both Medicare and provider’s interests, Noridian has comprised the following suggestions for providers who utilize third-party companies.

  • Carefully review all contracts signed with any billing agency and clearing house.
  • Ensure these agencies are not further contracting their work to additional companies without your full approval.
  • Strictly monitor which individuals have access to your patient’s Protected Health Information (PHI) and Personal Identifiable Information (PII).
  • Ensure all employees working with Medicare information are trained how to use NMP, IVR, remits, and Noridian’s public website.

To assist our providers with common questions they may have, Noridian has comprised a list of helpful Tools we hope will benefit your offices.

 

            Last Updated Tue, 22 Nov 2022 17:49:10 +0000