Description: This tutorial is intended to demonstrate functionality of the claim status feature in the portal, the majority of images reflected what the DME suppliers would see.
The self-paced tutorial is focused on claim status in the nuridium Medicare portal, the information given in this training is correct. This tutorial is intended to demonstrate functionality of the claim status feature in the portal, the majority of images reflected what the DME suppliers would see, however the navigation inquiry fields and responses appropriately reflect what all providers would experience, when using this feature.
Topics covered include the hours inquiry elements result and the ability to view nuridium examine or comment for select applicable claim, the hours of availability website resources and nuridium staff available to help with access or functionality question differ for Medicare contract.
First, the hours of availability for jurisdiction are listed which includes California, Nevada, Hawaii, American Samoa Guam and the Northern Mariana Islands, the hours for jurisdiction F are provided the states, within this jurisdiction are Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming, jurisdiction D DME includes the West Coast States and the hours of availability are listed here.
After logging into the portal, select claim status from the top menu or select start inquiry under the claim status description. To obtain claim status, first select the ten NPI and P ten from the drop-down, next enter the beneficiary Medicare number, first and last name and date of birth. The name must be entered exactly as provided on the Medicare card.
To narrow down the number of results, providers are encouraged to enter a date of service or a date span in the claim details section, providers may also use any of the other filter which is listed on the inquiry page.
Once the claim status has been submitted, a list of claims matching the criteria is displayed, this listing includes the claim number date of service, status of the claim total charge state, the claim was finalized, check number and the amount paid to the provider, the options to begin a new inquiry or to print this page are available above the results.
To view a specific claim, select view claim on the right side of the table part, a claim status details provides the following information amount paid to the provider deductible state. Meridian received the claim MSP indicator crossover indicator and check number among other items to the right of this information options are available to submit an appeal.
If applicable view of the most recent checks issued to this provider, view the claim specific remittance advice and to view nuridium medical review comment, if the claim was reviewed below that individual, claim line details are provided and this includes states of service CBT, hickspicks codes, modifier diagnosis code and the reason code.
At the bottom of the page, the description of each code used on the claim is provided, specific claim information is provided, however the option to view full remittance advices is also provided on the upper right side.
The clean line details for Part B include data service, the code modifier number of units, place of service, diagnosis code, the reason code. The description of the recent code is below the claim lines, if a part be a claim has denied or payment was reduced due to national correct coding initiative edit create or post-operative care, following a service that had a global period or due to a duplicate claim information causing this is displayed, select the related claim details link in the blue header, the related claim details display below of the reason code again.
DME is very similar, in the top section the beneficiary state is provided instead of an MSP indicator, the claim Line details include the date of service, bigfix code, modifier units, place of service, diagnosis code, billed amount, allowed amount, provider paid amount and the reason code.
If the claim had a history of being reviewed for additional documentation, the portal offers a comment button in the blue header section, after selecting this option, the claim processing comments will be retrieved and presented. Under the reason code there may be a rare occasion where the ability to view comments is offered. However a comment may not be available if that situation occurs.
Contact the nuridium call center if you have questions on the final outcome of the process claim. We published system downtime to the portal home page, you can see them on our community. If you have technical difficulties using the portal, first check the home page for any reported errors, if new ideon does not have an alert regarding the performance, contact our office, we can then investigate to determine what the portal should have returned and report the performance issue.
Thank you for completing the claim status tutorial, we hope you find this information helpful.