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

Last Updated May 10 , 2024