Wednesday, September 18, 2013

Noridian Online Provider Services for Medicare Eligibility, Claim Status and More

Noridian has launched their online provider services (OPS). If you were already a member of the Palmetto OPS then you should receive an email from Endeavor (Noridian OPS). The email will give you a login and password to log into the site.

You will be prompted to change your password. There is a ridiculously long list of can and cannot for your password:

Password Policy: 
  • Maximum Length: 8  
  • Minimum Length: 8  
  • Minimum Lowercase: 1  
  • Minimum Number of Character Type Rules That Must Pass: 4  
  • Minimum Numeric: 1  
  • Minimum Special: 1  
  • Minimum Uppercase: 1  
  • Must not contain values of attributes: accountID, email, firstname, lastname  
  • Must not contain words: ", `, ~, !, (, ), _, -, +, =, {, [, }, ], |, \, :, ;, ^, ', <, ,, >, ., ?, /, 0, 1, o, O, i, I, l, L, &

On Endeavor you will be able to:
  • Verify beneficiary eligibility
  • Claim status
  • Remittance advice
  • Reopening/appeal status
  • DME overpayment inquiries
  • PMD prior authorization status

Once you verify a beneficiaries eligibility you can review the following benefit information:
  • Eligibility
  • HMO/MCO coverage
  • MSP (Medicare secondary payer) coverage
  • HHEH (home health eligibility history)
  • Hospice, hospital, SNF (skilled nursing facility)
  • ESRD (end stage renal disease)
  • Preventative services

I particularly like the preventative services information. Endeavor lists the CPT code for a preventative service, then a description of the service and the next eligible date that the beneficiary can receive these benefits. This takes the guess work out of, "have you received a physical anywhere else in the last year?". I wish they would do this with more limited/global services.

Endeavor offers tutorials for use of their OPS site.

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