Appeals Now Processed Using the Medicare Appeals System (MAS) - Medicare Part A

CMS selected Noridian to participate in a Pilot Program for the Medicare Appeals System (MAS). MAS is an appeals processing system that will allow submitted appeals documentation to be stored and shared more easily by the entities processing the different levels of appeals. It is anticipated that this system will eventually be used by all Medicare Administrative Contractors (MACs). All Part A appeal requests submitted to Noridian with a receipt date of March 1, 2014, and after are being processed through MAS. Appeal status information continues to be available via the Provider Contact Center (PCC), the provider Remittance Advices (RAs), and Noridians’ provider portal (Endeavor); however, with the change to MAS, the endeavor appeals status details are now limited. Users can view the receipt and completion of an appeal but are no longer able to view any submitted documentation. Noridian has been made aware that some appeals status’ are not correctly listed in Endeavor, meaning that the appeal is not listed at all or shows as still pending when its actually been completed. Noridian is working diligently to correct this issue but in the interim if you question the information that Endeavor has listed for your appeal, please call the PCC at 1-877-908-8431.

In addition to the new appeals system, CMS has approved a change in the kind of appeal decision letters that will be mailed to the provider community. Beginning March 1, 2014 and forward providers will only receive denial/dismissal decision letters for appeals processed through MAS. Favorable appeal decision letters will no longer be sent. The RA containing the reprocessed claim will serve as notification to the provider that the appeal has been completed.  Sample appeals were needed to test MAS prior to the March 1, 2014, receipt date. Noridian chose the state of Arizona for our testing processes therefore; Arizona appeals are already following the new denial/dismissal letter process.

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INDUSTRY NEWS TAGS: Mac JF, Noridian Healthcare Solutions

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