Medical Review - JE Part B
Medical Review Frequently Asked Questions (FAQs)
Q1 How do we make sure we are getting our Noridian Medicare Targeted Probe and Educate (TPE), or New Provider Review (NPR) Notification/Findings letters and the additional documentation request (ADR) letters?
A1: You can now designate a Medical Record Correspondence Address (MRCA). If the MRCA is active, it will only be used for pre-pay and post pay medical review ADRs and the Notification/Findings letters for the review(s). The system will default to the existing provider addressing functionality if an active MRCA is not available or if a development letter does not involve a medical review request. To update the MRCA utilize the CMS-855I form (Section 2E) for individual physician and non-physician practitioners or the CMS-855B form (Section 2A4) for groups and organizations. The forms are located at Provider Enrollment.
Refer to PECOS to verify the address to which letters are to be mailed. If the address is verified as being correct, and you are expecting letters at that address but not receiving them, reach out to the person at that address so that the correspondence can be found and passed on to you. Also enroll in the Noridian Medicare Portal (NMP). The portal allows End Users access to the ADRs and Notification/Findings letters. Please refer to Noridian Medicare Portal (NMP).
Q2: Does Noridian/CMS allow E-Visits to be recorded?
A2: CMS/Noridian does not allow recording of the E-visits as there is proprietary/confidential information. Please refer to the slides that are emailed closer to the date, for your reference. Noridian/CMS does not provide consent.
Q3: How do I know what signatures are valid for Medicare?
A3: Review the medical documentation signatures page on the Noridian website, and the Internet Only Manual. These sites provide education and information related to valid signatures. Refer to: Signature Requirements and CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 3.
Q4: Who can I contact to assist with finding Additional Documentation Request (ADR) and other letters on the Noridian Medicare Portal?
A4: For assistance with the Noridian Medicare Portal you can contact the Provider Contact Center for your jurisdiction. For JE call 855-609-9960.
This link will take you to phone numbers for the Provider Contact Center and contains additional links for information regarding registering for the Noridian Medicare Portal: Noridian Medicare Portal
The Noridian Medicare Portal User Guide can be located here: User Guide
The case manager for your case can also provide assistance regarding finding your letters on the Noridian Medicare Portal by providing a PDF that shows how to access letters and can direct you to the appropriate people to reach out to for questions.
