Provider Enrollment

The Provider Enrollment function provides access to status of enrollment applications, upload additional information requested to process applications, and download the completed notification letter.

Enrollment Inquiry-Searching for an Application Number

  • Under the Provider/Supplier Details, select the TIN or SSN, NPI and PTAN needed. The Provider/Supplier will automatically populate along with the Program type. Program will only show MEDA or MEDB.

This image displays the Provider Enrollment Inquiry

  • In Application Details, select either Individual for an individual enrollment or Organization for an organizational enrollment. If information is not found under Individual, select Organization. If information is not found under Organization, select Individual.
  • Helpful Hint: If searching for a MEDA application, only Organization can be selected.

This image displays the Application Details with the Individual Enrollment Type selected

  • If applicable, place the application number in the Application/Reference Number field. Or, the Web Tracking ID in the Web Tracking ID field.

This image displays the Application Details with the Organization Enrollment Type selected

  • A Date Range can be selected.
    • This is not required.
  • Select View Applications.
  • If incorrect information has been entered in any of the fields, select Clear Form at the bottom of the page.

This image displays the Provider Enrollment inquiry Date Received Details

Enrollment Inquiry Results

  • At the top of the screen, the enrollment information searched will be shown.

This image displays the Provider Enrollment Inquiry Results

In Process Applications

  • Located here are the applications that are currently in process.

This image displays the In Process Applications

  • The columns will show the following:
Field Description
Type Type of application submitted. 855I, 855B, 855A, 855R or 855O
Submission Method Submitted either Web or Paper
Application Number Application number for the application submitted
Web Tracking ID Web Tracking ID for the application submitted
Date Received When Noridian received the application
Current Status What stage in processing the application is currently in
View View the requested information needed for the application. This will also remain blank if nothing is requested
Action Needed Submit New Correspondence or Correct and Resubmit Through PECOS. This means that corrections to the application are needed. This will also remain blank if nothing is requested

Completed Applications

  • Located here are the applications that are completed. The completed notification letter can be downloaded under the View column.

This image displays the Completed Applications

  • The inquiry will show the following:
Field Description
Type Type of application submitted. 855I, 855B, 855A, 855R or 855O
Submission Method Submitted either Web or Paper
Application Number Application number for the application submitted
Web Tracking ID Web Tracking ID for the application submitted
Date Received When Noridian received the application
Date Completed Date the application was completed
Completed Status This will show Approved, Returned or Rejected
View View Correspondence will allow the completed Notification Letter to be downloaded
More Information Get More Information will redirect to the Noridian Medicare Status Explanations. This will give more guidance on what to do next for the enrollment.

 

  • Get More Information can be selected as well. This will take you to the application status search tool. Below the tool, are Status Explanations. This will give you detail on the status of your application means.

This image displays shows the Get More Information link in the Completed Applications table

Downloading the Completed Notification Letter

  • Search for the enrollment needed.
  • Under the Completed Application section, select View Correspondence.

This image displays the View Correspondence link in the Completed Applications table

  • Select Download under the View Column. Save the Notification Letter to computer.

This image displays the View Correspondence Results

View Correspondence

  • To view requested revisions for an application that is in process, after searching for the application; select View Correspondence. Supporting Documentation can be uploaded at this time.
  • Helpful Hint: Supporting documentation will only be allowed to upload if Pending Corrections From Provider is showing in the Current Status column.

This image displays the View Correspondence link in the In Process Applications table

  • After selecting view Correspondence, select Download in order to review the requested revisions.

This image displays the Download link in the In Process Applications Documents table

  • From this screen, the requested revisions can be uploaded. Select the Submit New Documentation button.
  • A brief description of the document being uploaded is required.
  • Once that is entered, browse for the document on the computer and then select submit. Repeat as many times as needed.

This image displays the box to enter a description for the document to be uploaded

  • Once submitted, the documentation will be attached to the application that is currently in process. A document ID will populate after the document is uploaded successfully. This number can be saved if needed for future reference.

This image displays that a file was uploaded successfully

  • Once finished, select Back to Enrollment Results in the left-hand corner.

This image displays the Back to Enrollment Results button

Submit New Correspondence

  • If only needing to upload requested additional information, select Submit New Correspondence.

This image displays the Submit New Correspondence link

  • From this screen, the requested revisions can be uploaded.
  • Select the Submit New Documentation button. A brief description of the document being uploaded is required. Once that is entered, browse for the document on the computer and then select submit.
  • Repeat as many times as needed.

This image displays the Submit button

  • Once submitted, the documentation will be attached to the application that is currently in process. A document ID will populate after the document is uploaded successfully. This number can be saved if needed for future reference.

 

Last Updated Nov 21, 2018