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Implementation
Questions and Answers
General
Question:
Will Noridian maintain a physical presence in the JE jurisdiction?
Response: Noridian will have an office located in
the state of California to assist with the call center operations. We
will also be pursuing onsite representation for provider education
and Contractor Medical Director.
Question: Are
there any payment delays projected to occur at the time of
implementation?
Response: No payment delays are anticipated at the
time of implementation.
Question: What
are the hours of operation for the Noridian Call Center?
Response: The Noridian contact center
will be open 6am to 4pm PT Monday through Friday.
Question:
What are the hours of operation for the Noridian IVR and what
options are available?
Response: For Part A: Monday-Friday: 6 a.m. to 8
p.m. CT for Claim Status, Check Status and procedure code
pricing. The IVR is available 24 hours a day, 7 days a week
for eligibility, seminars, phone numbers addresses and appeal
rights.
Available options on our Part A IVR are: Patient Eligibility,
Claim Status and Claim Details, Check Information, Remittance
Advice, Patient Status, Preventive Services Information and
General question information such as HMO, Code Definitions
or CERT information.
For Part B: Monday-Friday: 6 a.m. to 8 p.m. CT for Claim
Status, Check Information, Remittance Advice, Patient Status
and Preventive Services. The IVR is available 24 hours a day,
7 days a week for Eligibility.
Available options on our Part B IVR are: Patient Eligibility
which includes Managed Care, MSP, Claim Status, Claim Detail,
Financial (Offsets, Pending Approved), Procedure Code Pricing,
Seminars, Addresses, and Appeal Right information.
Question: How
will any pending workloads be handled?
Response: All workloads currently held
by the outgoing contractor at the time of cutover will be
transferred to Noridian. This includes work in progress and
work not yet started. We do not anticipate the need for any
of the work that has been sent to Palmetto GBA to be resubmitted
to Noridian.
Question:
Since Noridian is our DME MAC and now our A/B MAC can we submit
Part B and DME claims together?
Response: No. Medicare Part B and Medicare
DME are two different contracts and will still need to be
submitted separately.
Question: How
are Recovery Auditor (RA) appeals handled?
Response: It is important to clearly identify
if the appeal is RA related in the Appeal request. Incoming
receipts are checked to see if the request is related to an
RA activity. Once a RA appeal is identified, all recoupment
activities are suspended pending disposition of the appeal.
Question: Do
you have a Provider Portal?
Response: Noridian does have a provider
portal which is called Endeavor. We will be working with Palmetto
GBA to determine the most efficient way to transfer information
about providers who have access to the current Palmetto GBA
portal to Endeavor. More information will be provided on expectations
of providers to have access to Endeavor after reviewing the
options with Palmetto GBA and CMS.
Question:
What services does your Provider Portal offer?
Response: Noridian’s portal, Endeavor, is a secure
Website. The portal functionality applicable to Part A and
Part B providers currently includes:
o
Eligibility 24 hours a day / 7 days a week with the exception
of CMS scheduled maintenance
o
Claim status inquiries
o
Claim-specific remittance advice in the format of a Standard
Paper Remittance Advice or MREP file
o
Written Reopening and Redetermination Submission; including
the ability to submit supporting documentation
o
Appeal Status Inquiries
Registration is completed
online via the Noridian website. We (Noridian) are responsible
for assigning user Endeavor IDs and terminating access. More information
will be available to providers when the JE implementation approaches.
Question:
What are the hours of availability for the Provider Portal?
Response: Monday-
Friday: 6am-8pm (central time) Saturday: 7am-3pm (central
time)
Question: What
are the JE implementation cutover dates?
Response: Part
A cutover is August 26, 2013 and Part B is September 16, 2013.
What
is meant by the “cutover date”?
Response: This
means that Noridian will take over the work of the outgoing
Medicare contractor on the specified date. It is important
to note that the outgoing Medicare contractor will transfer
all pending and in-process operations to Noridian on the designated
cutover dates.
Does
the fee schedule change due to the implementation to Noridian?
Response: The
implementation of the JE A/B MAC does not change your fee
schedule. The fee schedule is determined based on geographical
area, relative value units, etc.
Provider
Enrollment
Question: What
will happen to enrollment applications currently in-process
at the time of implementation?
Response: All Enrollment applications in process
but not yet complete will be transferred to Noridian.
Question: Will
there be a way to verify that Noridian has a pending revalidation
application?
Response: All pending revalidations will
be transferred to Noridian at the time of cutover. Noridian
will be able to confirm that an application has been received
and is in process by calling our contact center and providing
an NPI, or, providers can use our online tool which provides
status on applications in process. This tool can be accessed
within the enrollment section of the Noridian website.
It is important to keep in mind that contractors have up
to 180 days to process an application and that if it was recently
submitted; it may not have gone through the initial review
process and any requests for additional information if needed.
Question: How
will this implementation affect the revalidation process?
Response: All pending revalidations will
be transferred to Noridian at the time of cutover. All future
revalidation mailings will be facilitated by Noridian.
Question: When
should we stop sending enrollment applications to our current
contractor?
Response: Continue to send enrollment
applications to your current contractor until instructed otherwise.
We will provide more information, if needed, as we move closer
to the time of implementation.
Question:
Will I be required to complete a new CMS-855 Enrollment Application?
Response: Providers will not be required
to complete a new CMS-855 Enrollment Application. After cutover,
Noridian will have access to all provider enrollment data
previously captured and maintained by the outgoing contractor.
The possibility of providers still having to do the revalidation
still exists which will require a new CMS-855 enrollment application.
You will receive a letter from Noridian indicating that an
application is required for this as part of this process.
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