Providers are responsible for verifying eligibility every time a member is seen in the office. Primary care providers should also verify that a member is assigned to them. Show Eligibility can be verified through:
Providers are required to utilize self-service options such as Noridian Medicare Portal (NMP) and the Interactive Voice Response (IVR) system to retrieve claim status and beneficiary eligibility details such as. Customer Service Representatives (CSRs) will refer providers to these resources. To fully comply with this requirement, Noridian requires providers to obtain the below information from self-service options, when available. Providers without access to NMP must coordinate with his/her employer to gain access. Beneficiaries must contact Medicare by calling 1-800-Medicare (1-800-633-4227). Access the below related information from this page:
Noridian Medicare PortalLogin/Register: https://www.noridianmedicareportal.com/ Visit the Portal Guide for additional resources including: Registration Guide, Inquiry Guide, and Education on Demand videos Inquiry Hours of Availability:
Password/Registration Support: User Security:
Interactive Voice Response (IVR)Visit the IVR Guide for more details. Phone: 855-609-9960 Hours:
Note: Eligibility related information provided at the time of an NMP and/or IVR inquiry is as correct and current as available; however, changes may occur daily as Medicare, the Social Security Administration, Health Maintenance Organizations, Home Health Agencies, inpatient facilities, etc. initiate updates to a patient's national file. Due to such ongoing changes, the PCC CSRs will no longer provide callers with an Inquiry ID as a form of NMP and/or IVR information validation for these situations. Provider Contact CenterBe prepared to have the following information ready:
Note: CSRs can assist with three (3) inquiries per call. Phone: 855-609-9960
Hours:
Telecommunications Device for the Deaf (TTY): 855-549-9874 TTY Hours:
User SecurityUser Security staff assist with:
Phone: 855-609-9960 Option 5 Hours:
PCC Assistance StructureNoridian uses a triage approach to manage provider inquiries in accordance with CMS Internet Only Manual (IOM), Publication 100-09, Medicare Contractor Beneficiary and Provider Communications Manual, Chapter 6, Sections 30.1, 30.5 and 30.5.1. The use of self-serve technology enables the PCC to more efficiently handle the increasing volume of provider calls by allowing providers access to certain information without direct personal assistance from contractor staff. View official instruction in CMS Change Request CR3376. Resources
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Medicare eligibility verification phone number for providers
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