Provider Contact Center (PCC) - JE Part A
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.
- Claim Status
- Claim Detail
- Claim Processing Comments
- Financial information (checks)
- Appeal Status
- Request Appeal
- Remittance Advices (RAs)
- Self Service Reopenings
General inquiries available 24/7.
For more IVR details, see the IVR Guide.
Note: Eligibility related information provided at the time of an NMP and/or IVR inquiry is as correct and current as available; however, changes may occur daily as Medicare, the Social Security Administration, Health Maintenance Organizations, Home Health Agencies, inpatient facilities, etc. initiate updates to a patient's national file. Due to such ongoing changes, the PCC CSRs will no longer provide callers with an Inquiry ID as a form of NMP and/or IVR information validation for these situations.
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. - 2:30 p.m. PT
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.
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 34
- CMS IOM, Publication 100-09, Medicare Contractor Beneficiary and Provider Communications Manual, Chapter 6, Section 30.1.1 and 50.1 - CMS Self-Service Requirements
- CMS Medicare Learning Network (MLN) Matters Special Edition (SE)0916 - Prior authorization
Last Updated Thu, 06 Aug 2020 16:53:13 +0000
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.