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EDI Partners Teams with Noridian Healthcare Solutions to offer EDI Outsourcing Services for Healthcare Payers

FARGO, N.D. (April 3, 2017) – Supporting a more cost effective electronic data interchange (EDI) model for healthcare payers, EDI Partners has teamed with Noridian Healthcare Solutions (Noridian) for EDI outsourcing services. The services supported by the partnership will include data collection and communication between the healthcare provider and payer in support of all business functions including eligibility verification, claims collection, claims status, claims remittance, and clinical information exchange. EDI Partners will support the core X12 transactions established by the Health Insurance Portability and Accountability Act (HIPAA) and will be charged with supporting new versions of the transactions as required by the U.S. Department of Health and Human Services (HHS) as well as a focus on working with a payer’s trading partners to ensure controls are in place to resolve issues based on a payer’s service-level agreements (SLAs). ”EDI Partners chose to partner with Noridian Healthcare Solutions because of their experience, expertise and ability to deliver cost effective quality solutions for their government and commercial healthcare clients,” stated Kent Benton, President and CEO of EDI Partners. Operations supported by Noridian will include receiving, editing and validating the transactions, and reformatting and delivering the transactions to their appropriate destination. Mr. Tom…
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Noridian Healthcare Solutions awarded CMS Unified Program Integrity Contract (UPIC) IDIQ

FARGO, N.D. – (July 12, 2016) Noridian Healthcare Solutions (Noridian) has been awarded an Indefinite Delivery Indefinite Quantity (IDIQ) Unified Program Integrity Contract (UPIC) by the Centers for Medicare & Medicaid Services (CMS) after a full-and-open competitive procurement. Under this award, Noridian is one of seven contractors who will bid on future task orders to participate in the CMS’ initiative to consolidate fraud, waste and abuse programs. Noridian President Tom McGraw said, “Noridian is honored to have this opportunity to increase our role working with the Center for Program Integrity on this very important initiative. We look forward to delivering the highest quality service to the Medicare and Medicaid programs.” This 10-year award is part of CMS’ new $2.5 billion dollar initiative to combine and integrate existing CMS program integrity functions carried out by multiple contractors and contracts under the UPIC program. The program integrates audit, oversight and antifraud, waste and abuse activities for all government healthcare programs. This change improves CMS’ capacity to swiftly anticipate and adapt to the ever changing and dynamic nature of those involved in health care fraud, waste, and abuse across the Medicare and Medicaid program integrity continuum. “Noridian is excited to have been selected…
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Noridian Healthcare Solutions awarded CMS DME Jurisdiction A contract

FARGO, N.D. – (December 18, 2015) Noridian Healthcare Solutions, LLC (NHS) has been awarded the Durable Medical Equipment Jurisdiction A (DME JA) contract by the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human Services, concluding a full-and-open competitive procurement, and nearly doubling NHS’s current DME workload. NHIC Corp. currently administers this contract. “The award recognizes NHS’s strong performance as a Medicare administrative contractor (MAC) and our ability to successfully transition workload and provide strong, consistent value throughout the contract term,” said Tom McGraw, President and CEO. “This contract is a direct reflection of the great work our staff does each day.” Under the DME JA contract, NHS will administer Medicare claims from suppliers of DME, prosthetics and orthotic supplies in 12 states: Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont. DME JA accounts for approximately 18% of the national Medicare DME claims volume. The contract period for the new award includes a base year and four one-year renewal option years, with a total value of more than $90.9 million. Beginning with a single Medicare contract in 1966 serving Medicare beneficiaries only in North…
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Noridian Healthcare Solutions re-awarded CMS DME Jurisdiction D contract

FARGO, N.D. (September 10, 2015) – Noridian Healthcare Solutions, LLC (NHS) has been re-awarded the Durable Medical Equipment Jurisdiction D (DME JD) contract by the Centers for Medicare & Medicaid Services (CMS), concluding a full-and-open competitive procurement. NHS has administered this contract since 2006. “This re-award reflects NHS’s exceptional Medicare claims administration performance, as well as our ability to implement innovations and enhancements to provide strong value throughout the contract,” said NHS President and CEO Tom McGraw. “The performance of the NHS DME team reflects our commitment to performing at a high level for our customers.” Under the DME JD contract, NHS administers Medicare claims from suppliers of DME, prosthetics and orthotic supplies in Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington and Wyoming. The contract period for the new award includes a base year and the option for four one-year options, with a total value of more than $137.7 million. Staff supporting the DME JD contract are located in NHS’s Fargo headquarters and throughout the country. Beginning with a single federal Medicare contract in North Dakota in 1966, today NHS serves as a…
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