Skip to main content

Medicare - Novitas Appeals Inquiry Status Tool

According to Novitas :
 
This tool provides the status of Part A and B Appeal requests.
Once you have entered your search criteria (defined below), click on "Submit Query". Do not hit the enter key. Search results are based on exact matches of the input criteria. Please ensure you enter search data exactly as it appears on your remittance advice or voiced from the IVR.

You may not receive the results you are looking for if you submitted a multiple claim appeal using only one Redetermination form
.  The case pending in our processing system will reference only one of the claim numbers. 
For multiple claim cases submitted with one Redetermination form it is suggested to search using only the PTAN.
And…
If you submitted a Redetermination request form and did not provide a claim number the case pending in our processing system will not reference a claim number initially.  If you search using only the PTAN, you will see an open case, the receipt data and the status but it may not reference an ICN.
Redeterminations will be completed within 60 days of receipt of the request unless additional documentation is submitted by the provider/supplier and received by Novitas prior to issuance of the dismissal and/or decision notice. 

Part A Search Criteria:

Notice Issued February 3, 2014 – Novitas Solutions is in the process of implementing a new Medicare Appeal Processing System.  As efforts are underway to re-direct the Appeals Status tool to the new processing system, current receipts will not be returned on your query until March 1, 2014. 
Case Control Number (CCN) – displays status for a specific Appeal request
Provider Transaction Access Number (PTAN) – displays status for all Appeals submitted by this PTAN for the past year.
Provider Transaction Access Number (PTAN) and Document Control Number (DCN) - display status of Appeal requested for a specific case
Please note that 1 year of history will be available.

Each Part A response will include the following information:

Date the case was received
Case Control Number (CCN)
Type of Case – The Part A tracking system uses the same case number for all case types, therefore type is provided to differentiate.
Status of Case – Pending or finalized
Closed date of case if finalized
Document Control Number/claim number (DCN)

Part B Search Criteria:

Case Control Number (CCN) – displays status for a specific Appeal request
Provider Transaction Access Number (PTAN) – displays status for all Appeals submitted by this PTAN for the past year.
Provider Transaction Access Number (PTAN) and Internal Control Number (ICN) - display status of Appeal requested for a specific claim.

Each Part B response will include the following information:

Date the case was received
Correspondence Control Number (CCN)
Status of case – pending or finalized
Closed date of case if finalized
Internal Control Number (ICN) for claim in question

Field Definitions:

(*) = required field
Case Control Number (CCN) – This is a 13 digit number assigned to the Appeal request.
Provider Transaction Access Number (PTAN) - The number assigned by the Medicare
Administrative Contractor (MAC) that is used by the MCS system to process claims.
Document Control Number (DCN) – This is a 13 digit number assigned to the Part A claim during the initial processing, found on your remittance statement or voiced in the IVR.
Internal Control Number (ICN) - The 13 digit number assigned to the claim during initial processing, found on your remittance statement or voiced in the IVR.
NOTICE: Currently, Appeals may not be entered in the Appeals Status Tool as expected. Therefore, using this tool may not be an accurate method to determine if an Appeal request has been received by Novitas. Please do not resubmit Appeal(s) or call the Customer Contact Center repeatedly as these actions compound problems.

Please click on below link to get the Appeals Inquiry Status Tool

 

Comments

Popular posts from this blog

What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare  Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria:  Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits.  Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition ...

Key Performance Indicators (KPIs) for Successful Revenue Cycle Management (RCM) in Healthcare Organizations

 Revenue Cycle Management (RCM) is an essential process for healthcare organizations to ensure that they receive timely and accurate payments for the services they provide. Here are some of the key performance indicators (KPIs) metrics that healthcare organizations should track as part of their RCM process: Gross Collection Rate (GCR): This metric measures the percentage of charges that a healthcare organization collects from patients and insurance companies. It is calculated by dividing the total payments received by the total charges billed. Net Collection Rate (NCR): The NCR measures the percentage of expected payments received by the healthcare organization after accounting for contractual adjustments, bad debts, and other adjustments. It is calculated by dividing the total payments received by the total expected payments. Days in Accounts Receivable (DAR): This metric measures the average number of days it takes fo...

What is W-9 form? Why it is required for Medical Billing.

W-9 Form W-9 is Internal Revenue Services (IRS) request for Tax Payers identification number, mainly its used for third parties to collect ID information like Name, Address to help file information returns with IRS. Also its is used to help payee avoid backup withholding. It is required for your name, Address and SSN number or employer identification number. When your giving out W-9 form be caution, because W-9 form contains sensitive information’s. Why Insurance Company ask W-9 Form from hospital or clinic etc., Because medical billing is cycle indirectly or directly insurance company’s are working for hospital or clinic etc., for them we need to report SSN number / business tax id. As far as       W-9 is form is concern it is straight forward with the all the above mentioned information, also they need to pay to address, or to update their records, or to check / update records. Note: W-4 Form is used by employer ...