Self Service Reopening (SSRO) Mandate Assistance - JE Part B
Self Service Reopening (SSRO) Mandate Assistance
Q1. When did the SSRO Mandate begin?
A1. The mandate began on October 1, 2020.
Q2. Will Phone Reopenings still be available?
A2. Phone Reopenings will only be available for reopening adjustment types not offered on the portal.
Q3: How can a SSRO be performed?
A3: A SSRO can be performed under the claim status option on the Noridian Medicare Portal (NMP). After a user searches for a claim, they have the capability to view the claim's details and select it for a SSRO. Further guidance can be located on NMP's Self service Reopenings (part B) page.
Q4. What should be done if a provider does not have internet or NMP access?
A4. Usage of NMP will be expected for all callers who have computer and internet access. If a provider does not have access to the internet, they may print off the Written Reopening Form located on the Noridian website's Forms page. The Reopening Form is found under the Appeals Forms section.
Q5. What if only one person is authorized to use NMP in an office?
A5. That authorized person would perform the required SSRO corrections or their management would need to allow others to have a NMP account.
Q6. Is there a list of adjustment types that can be made through a SSRO?
A6. A list of possible corrections is located on NMP's Self service Reopenings (part B) page.
Q7. If an adjustment type is not available, how can a written reopening be requested?
A7. When the adjustment type is not available on NMP, the provider can call Phone Reopening or submit a Written Request. The Written Reopening Form is located on the Noridian website's Forms page. The Reopening Form is found under the Appeals Form section.
Q8. Can providers who only submits paper claims register for NMP even though they do not submit electronically?
A8. Providers who submit 1500-claim forms can register for NMP, but must work with Noridian's Electronic Data Interchange (EDI) department for a submitter ID. Their National Provider Identifier (NPI) must be registered and be in production for at least one transaction in Electronic Data Interchange Support Services (EDISS) Connect before it can be eligible for NMP. These transaction options include:
- 837P/837I Claim Submission
- 835 Electronic Remit
- 276 Batch Claim Status Request
The set-up time frame for a new NPI in EDISS Connect is 7-10 business days. Once an NPI has completed at least one of the transactions listed above, it can register for additional transactions such as, NMP.
Q9. Is there a limit to how many providers can be under one account?
A9. There is no limit to the number of end users under one account.
Q10. Can claims over a year old be adjusted in NMP?
A10. If a claim is over a year old, the only adjustment type available will be to deny a line or entire claim as 'Billed in Error.' This can be performed by selecting "yes" to the question "Is this an overpayment refund?" NMP cannot make any other corrections in this situation.
Q11. What can be done if a SSRO is started but the transaction could not be completed?
A11. At any time before submitting the correction, a user can go back and correct any mistakes. If they no longer want to correct the claim, they can close out of the claim and no correction will be saved.
Q12. Can a claim with a line adjusted as "Billed in Error" be reopened on SSRO?
A12. If selecting “Billed in Error” for a line item, additional adjustments can be made on other line items during the same SSRO session. However, once a claim is under review for “Billed in Error,” Reopenings should be contacted for additional changes. If wanting to adjust a specific line that has already been ‘Billed in Error,” a Redetermination or Resubmission will be necessary.
Q13. If there are multiple changes to be made through a reopening, can they be performed through NMP?
A13. NMP SSRO can make multiple changes through a single SSRO. Anything that is in the dropdown menu can be adjusted at the same time. However, once a provider corrects a line to “Billed in Error,” future corrections would need to be made through the Written Reopening Form.
Q14. If a claim has been previously appealed, would it be eligible for a SSRO?
A14. Once a claim is appealed, providers must follow the appeals process. If a provider has questions regarding an appeal or further adjustments, the Provider Contact Center should be contacted.
Last Updated Tue, 28 Jun 2022 12:51:39 +0000