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Provider Contact Center (PCC)

CMS requires contractors to provide self-service options for providers to retrieve claim status and beneficiary eligibility details. Noridian offers the Noridian Medicare Portal (NMP) and the Interactive Voice Response (IVR) system for such information which are available for extended hours throughout the day and weekend.

To fully comply with this requirement, Noridian requires providers to obtain the below information from self-service options, when available. Providers without access to NMP must coordinate with his/her employer to gain access.

NMP Inquiries and Functions

For more NMP details and a complete functionality listing, see the User Manual.

  • Eligibility
  • Claim Status
  • Claim Detail
  • Claim Processing Comments
  • Financial information (checks)
  • Appeal Status
  • Request Appeal
  • Remittance Advices (RAs)
  • Self Service Reopenings

IVR Inquiries

General inquiries available 24/7.

For more IVR details, see the IVR Flowchart [PDF].

Customer Service Representative (CSR)

It is expected callers have reviewed claim status information and their RA. To decrease call wait times and direct calls through our IVR system to the most appropriate department, callers must authenticate with their National Provider Identifier (NPI), Provider Transaction Access Number (PTAN) and Taxpayer Identification Number (TIN).

During the hours below, CSRs are available to assist callers with complex inquiries.

  • Electronic Data Interchange Support Services (EDISS): M-F 6 a.m. - 5 p.m. PT
  • Provider Contact Center (PCC): M-F 6 a.m. - 5 p.m. PT
  • Provider Enrollment: M-F 6 a.m. - 5 p.m. PT
  • Phone Reopenings: M-F 6 a.m. - 5 p.m. PT
  • User Security: M-F 6 a.m. - 3 p.m. PT

855-609-9960

TTY: 855-549-9874 (M-F 8 a.m. - 5 p.m. PT)

Beneficiaries must contact Medicare by calling 1-800-MEDICARE (1-800-633-4227).

NOTE: CSRs can assist with three (3) inquires per call

PCC Assistance Structure

Noridian uses a triage approach to manage provider inquiries in accordance with CMS Internet Only Manual (IOM), Publication 100-09, Medicare Contractor Beneficiary and Provider Communications Manual, Chapter 6, Sections 30.1, 30.5 and 30.5.1. The use of self-serve technology enables the PCC to more efficiently handle the increasing volume of provider calls by allowing providers access to certain information without direct personal assistance from contractor staff.

View official instruction in CMS Change Request (CR)3376.

Resources

Related Articles

Articles Posted
Enrollment Application Status Tool Use Required - Effective February 5, 2018 01/09/18
NMP and/or IVR Use Required for Eligibility Inquiries - Effective February 5, 2018 01/09/18
NMP, IVR, and Enrollment Application Status Search Required Use - Effective February 5, 2018 01/03/18

 

Last Updated Jan 09, 2018