Noridian reports spike in provider deactivations and lost revenue Noridian, Medicare’s administrative contractor for California, has seen a spike in the number of providers deactivated for not responding to Medicare revalidation notices, resulting in a gap in billing privileges and lost revenue for physicians. Noridian will send revalidation notices via email two or three months prior to the revalidation due date. Revalidation notices sent via email will indicate "URGENT: Medicare Provider Enrollment Revalidation Request" in the subject line to differentiate from other emails. If the email is returned as undeliverable, only then will Noridian will send a paper revalidation notice to the correspondence, special payments and/or primary practice address on file. Physicians don’t, however, have to wait for a revalidation letter. CMS has a look-up tool that allows a practice to look up an individual physician’s or organization’s revalidation date. Providers due for revalidation in the near future will display a revalidation due date. All other providers/suppliers will see "TBD" in the due date field. What physicians need to know: When responding to revalidation requests, it’s important to revalidate your entire Medicare enrollment record, including all reassignment and practice locations through internet-based PECOS or via the CMS 855 form. If you have multiple reassignments/billing structures, you must coordinate the revalidation application submission with each entity. If a revalidation application is received but incomplete, Noridian will contact you via email for the missing information. If the missing information is not received within 30 days of the request, Noridian will deactivate your billing privileges. Do not assume that “no news is good news.” The contact person indicated on the application should receive an email notice of the application receipt, any discrepancies, and either a stop billing privileges or acknowledgement letter of approval. Check your spam filter if you’re not receiving these notices. Failure to revalidate may result in a deactivation of your Medicare billing privileges. If billing privileges are deactivated, a provider request to reactivate will result in the same Provider Transaction Access Number, but there will be a lapse in coverage with Medicare. The provider will be required to submit a new full and complete application in order to reestablish the enrollment record and related Medicare billing privileges. If the revalidation application is approved, the provider will receive email confirmation that the provider will be revalidated and no further action is needed. For more information on the revalidation process, see MLN Matters #SE1605. If you have questions about the revalidation process, click here or contact Noridian by calling (855) 609-9960. September 25, 2017 Medicare Medicare, Noridian, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
Noridian Medicare announces web-based provider enrollment workshops Noridian, the Medicare Administrative Contractor for California, announced that it will offer web-based workshops focusing on provider enrollment. These webinars are intended for the Part B provider using the online Provider Enrollment, Chain and Ownership System (PECOS) to change enrollment information, track revalidation or set up a sole proprietorship. The Internet-based PECOS process can be used in lieu of the Medicare enrollment application (i.e., paper form CMS-855). The advantages of PECOS are: Faster than paper-based enrollment (45-day processing time in most cases, vs. 60 days for paper) Tailored application process means you only supply information relevant to YOUR application Gives physicians more control over their enrollment information, including reassignments Easy to check and update your information for accuracy Less staff time and administrative costs to complete and submit enrollment to Medicare There is no registration or teleconference fee. The presentations will be conducted through a web-based training tool that requires an Internet connection and a telephone (toll-free number provided in confirmation email). For more details and to register, visit https://med.noridianmedicare.com/web/jeb/education/training-events. October 14, 2015 Medicare Noridian, Medicare, PECOS, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
Noridian sends out another wave of Medicare revalidation requests As called for under the Affordable Care Act (ACA), Medicare Administrative Contractors (MACs) have been requiring physicians to revalidate their Medicare enrollments. Between now and March 23, 2015, MACs will continue reaching out to physicians, notifying them of the need to revalidate. The most recent round of revalidations requests went out by December 30, 2013. The revalidation requirement is necessitated by new screening criteria called for under the ACA. Newly enrolling and revalidating providers will be placed in one of three screening categories representing the level of risk to the Medicare program. The level of risk will determine the degree of screening to be performed when processing the enrollment application. Physicians who receive a request for revalidation must respond to that request within 60 days or face the possibility of being deactivated. Do not do anything until you get a letter instructing you to revalidate. (This is very important to ensure an orderly enrollment process.) Physicians who are making changes (moving, closing practice, etc.) should continue to submit their changes as usual. For providers in PECOS – the revalidation letter will be sent to the special payments and correspondence addresses simultaneously. If these are the same, it will also be mailed to the primary practice address. For providers NOT in PECOS – revalidation letters were sent earlier this year to the special payments or primary practice address. If you are not in PECOS and have not already received a letter, contact Noridian for guidance. To find out whether you have been mailed a revalidation notice go to the revalidation page on the Centers for Medicare and Medicaid Services website. If you are listed, and have not received the request, contact Noridian at (855) 609-9960. Contact: CMA reimbursement help line, (888) 401-5911 or mkelly@cmanet.org. February 7, 2014 Medicare Affordable Care Act, Medicare, Noridian, PECOS, ACA, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
