Tools - JE Part B
Tools
Acronyms and Glossary - View Medicare acronyms of common terminology. Not all-inclusive
Additional Documentation Request (ADR) Timeline Calculator - Calculate date Noridian must receive requested documentation
Administrative Law Judge (ALJ) Timeliness Calculator - Calculate ALJ submission deadline
Advance Beneficiary Notice of Noncoverage (ABN) Tutorial - Hover over form fields to identify details required for each
Ambulance Zip Code Definition Lookup - Use this tool to determine if the zip code being billed is urban, rural or super rural
Appeals Decision Tree - Determine if a claim appeal may be requested
Appointment of Representative (AOR) Tutorial - Hover over form fields to identify details required for each
CMS-1500 Claim Form Tutorial - View image of claim form and move cursor over Items for claim form completion details
Claim Submission Timelines Calculator - Calculate claim submission deadline
Denial Code Resolution - View common claim submission error codes, descriptions of issues and potential solutions
Documentation Requirements Checklists - View checklists to help identify records not routinely submitted by providers but must be available upon request
Education on Demand Tutorials - Access self-paced educational tutorials based on Noridian hosted webinars
ESRD 30 Month Coordination Calculator - Calculate 30 month coordination period prior to Medicare becoming primary insurance
Extended Repayment Schedule (ERS) Decision Tree - Provides a listing of the documentation needed with an ERS application depending on the length of the loan being requested
Global Surgery Date Calculator - Calculate the date when the global period ends for 10 or 90 day surgical procedures
Interactive Voice Response (IVR) Conversion Tool - Determine touch-tone number sequence to enter in IVR
Medically Unlikely Edit (MUE) Lookup Tool - Helps to determine the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service
Medicare Secondary Payer (MSP) Decision Tree - Determine if Medicare is primary or secondary payer
MSP Payment Calculator - Providers may enter specific amounts from the primary insurance company's Explanation of Benefits in addition to their billed amount to determine Medicare's payment (line-level, not full claim billed amount)
New vs Established Patient Decision Tree - Determine whether a patient is New or Established
NMP vs. IVR Self Service Elements Comparison - Guidance on accessing details via the Noridian Medicare Portal and/or the Interactive Voice Response
Noridian Medicare Portal (NMP) - Access web-based portal to check claim status, verify eligibility, review claim specific and full remittance advices, view claim processing comments, view pending and finalized check information issued, submit Reopenings and Redeterminations request, gain more information about a finalized claim that was denied or received a reduced payment due to related services, upload supporting appeal documentation and check appeal status
Overpayment Interest Calculators - These calculators are commonly used to determine how much interest have been accrued on an unpaid overpayment
Prior Authorization Look Up Tool - Determines which HCPCS codes require a Prior Authorization
Provider Enrollment Application Status Search - This search allows providers and suppliers to follow the application progress. Enter an Application/Reference Number or Web Tracking ID into its search field and select "View Application Status"
Provider Enrollment Corrective Action Plan (CAP), Reconsideration, and Rebuttal Decision Tree - This tool will assist the user in submitting a Provider Enrollment reconsideration request, corrective action plan or rebuttal.
Provider Enrollment On Demand Tutorials - View eligible Medicare Part B Specialties and Enrollment on Demand application tutorials to help such providers complete the appropriate applications correctly the first time
Reconsideration Timeliness Calculator - Calculate Reconsideration submission deadline
Recovery Auditor Determination Decision Tree - Determine correct action to Recovery Auditor claim review
Recovery Auditor Timeliness Calculator - Calculate time frames for Recovery Auditor activities
Redetermination/Reopening Form Tutorial - Hover over form fields to identify details required for each
Redetermination Timeliness Calculator - Calculate Redetermination submission deadline
Remittance Advice (RA) Tutorial - Hover over RA items to identify details of each
Reopening Timeliness Calculator - Calculate Reopening submission deadline
Site Map - View listing of primary and secondary website contents. Help and Contact information also available
Website Tour - High level overview of website content layout and design