New Provider New Biller

This page is designed for those that are new to Medicare as a provider or biller, someone who has been tasked with undertaking new roles within Medicare programs, or those looking for short videos to assist with their training program*.

*Videos are scheduled for annual reviews, try to listen each year for updates.

Getting to Know CMS and Noridian

Topic of Interest Description
CMS Internet Only Manuals (IOM) CMS guidance on day-to-day operation instructions, policies, and procedures that are based on statutes, and regulations guidelines.
Latest Updates News and updates from Noridian and CMS
Noridian Medicare Part A & B - YouTube Tutorials created by Part A and Part B. Short videos created to help you understand single aspects of a topic.
Contact Information Noridian Hours of Availability, email addresses, fax numbers, mailing addresses, as well as other points of contact.
Noridian e-mail sign up Sign up for our weekly ListServ to keep up to date on current Noridian and CMS topics
Medicare Learning Network Educational documentation for providers on CMS programs, policies, and initiatives
CMS Transmittals New or changed policies or procedures that will be incorporated in the CMS Online Manual System.

Understanding Medicare Self-Service Tools

Self-Service Tools Location
Noridian Medicare Portal User Manual User Guide with step-by-step instructions on how to complete each task available in the portal. This page also includes a link to the portal and explanation of the roles available in the portal.
Noridian Medicare Portal log-in Log in page for the Noridian Medicare Portal
Interactive Voice Response Access features of the IVR such as Availability, tips,
CMS Internet Only Manual (IOM), Publication 100-09, Medicare Administrative Contractor (MAC) Beneficiary and Provider Communications Manual, Chapter 6 Medicare guidelines for usage of the self-service tools.

Claim Submission

Location Explanation
Claims Instructions on how to complete each Item on the CMS-1500 claim form
Claim Form Tutorial Claim form tutorial that allows you to hover over each item of the claim form to determine what information should be in this field
Denial Code Resolution Description of common denials
Timely Filing Information on filing your claims on time
Electronic Data Interchange (EDI) Information and assistance on submitting electronic claims.
Remittance Advice (RA) Review important information about remittance advices
X12 Claim Adjustment Reason Codes Claim Adjustment Reason Codes
X12 Remittance Advice Remark Codes Remittance Advice Remark Codes

Appeals

Location Explanation
Forms Paper forms to submit for the five levels of appeals
Appeals Decision Tree Question and Answer format to help you determine if an appeal is the right step.
Appeals Monthly Newsletter Monthly newsletter to help you reduce claim denials as well as your appeals.
Five Levels of Appeals Page with information and resources for you on each of the five levels of appeals.
Timeliness Calculators Calculator to assist you in determining what date the appeal must be received by Noridian to be considered timely.
Documentation Requirements Informational page to assist you in determining what documentation should be submitted with your appeal. Includes section for specific requirements for specialty and topic documentation requirements.
Elements of a Redetermination Letter This page provides a summary of each section of a Redetermination letter.
Portal Guide - Noridian Medicare Portal (NMP) Written instructions showing how to do various tasks in the Portal, such as filing an appeal.

Medicare Topics

Topic of Interest Brief Details
Education and Outreach Explore Medicare educational opportunities via variety of strategies and methods. We offer Education on Demand tutorials which provide self-paced, pre-recorded Medicare Part B Billing related videos as well as live events such as webinars and Ask the Contractor Teleconferences (ACTs). See the Schedule of Events webpage to register.
Medicare Physician Fee Schedule (MPFS) Look up Medicare allowable amounts for physician services.
Policies Access CMS National Coverage Determinations (NCDs), and view Local Coverage Determinations (LCDs), Medicare Coverage Articles, MolDx, and Self-Administered Drugs (SADs) details.
Last Updated Sep 03 , 2024