Article Detail - JE Part A

Noridian wanted to provide information to help providers determine if a level one redetermination, or level two reconsideration, is needed to have claim denials reviewed.

Redetermination

Did your office recently receive information on a remittance advice that claims were denied?

• Complete a Redetermination paper form or;
• Complete the portal process for a Level 1 Redetermination

Reconsideration

Did your office recently receive a letter with an unfavorable decision, or a Medicare Redetermination Notice (MRN)?

• Complete a Reconsideration paper form or;
• Complete the portal process for a Level 2 Reconsideration

Appeals Resources

• Noridian Part A and B Appeals Tutorials
• CMS Internet Only Manual (IOM), Publication 100-04 Medicare Claims Processing Manual, Chapter 29 Appeals of Claims Decision