Identifying Managed Care Plans

Noridian receives numerous claims each month submitted incorrectly for managed care plans (HMO) or Medicare Part C plans.

It is the responsibility of the facility staff to routinely check the beneficiary’s Medicare coverage and inquire on any newly enrolled HMO plans. Beneficiaries should have a benefit card for Medicare and any HMO plans.

The Noridian Medicare Portal (NMP) provides HMO plan information if the beneficiary is enrolled. Using the Eligibility inquiry on NMP will ensure the claim is being sent to the proper payer the first time. Visit the Portal Guide to view instructions on how to use the Eligibility inquiry and check out the many Education on Demand videos on other NMP related topics.

            Last Updated Thu, 28 Jan 2021 17:40:48 +0000