Medicare Noridian refers to Noridian Healthcare Solutions, a Medicare Administrative Contractor (MAC) that processes Medicare Part A and Part B claims for specific geographic regions in the United States. If you live in or receive care in one of these regions, Noridian is the company that handles your claim payments, provider enrollment, and customer service for Original Medicare. Understanding what Noridian does, which areas it covers, and how it affects your coverage can help you navigate Medicare with fewer headaches.

What Is a Medicare Administrative Contractor (MAC) and Why Noridian Matters

Medicare does not process all its own claims. Instead, the Centers for Medicare & Medicaid Services (CMS) contracts with private companies called Medicare Administrative Contractors (MACs) to handle billing, payments, and provider education in specific geographic jurisdictions. Noridian Healthcare Solutions is one of these MACs. It operates under two main contracts: Jurisdiction A (JA) for Part A and Part B, and Jurisdiction D (JD) for Part A and Part B. Noridian also handles the Durable Medical Equipment (DME) MAC for Jurisdiction D.

For beneficiaries, this means that if you live in a state covered by Noridian, your Medicare claims for hospital stays (Part A) and doctor visits (Part B) are processed by Noridian. Your Medicare Summary Notices (MSNs) will come from Noridian, and if you have a question about a claim, you would contact Noridian’s customer service line. Providers in those regions also interact with Noridian for enrollment, billing guidance, and appeals.

Which States and Territories Does Noridian Cover?

Noridian serves two main jurisdictions:

  • Jurisdiction A (JA): Includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. This covers both Part A and Part B.
  • Jurisdiction D (JD): Includes Alaska, Arizona, California (most counties – check specific ZIP codes), Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming, and the U.S. territories of American Samoa, Guam, and the Northern Mariana Islands. This also covers Part A and Part B.

Additionally, Noridian is the DME MAC for Jurisdiction D, meaning it processes claims for durable medical equipment (like wheelchairs, oxygen, and diabetes supplies) in that region. If you live in a state not listed, your MAC is a different company, such as Palmetto GBA or Novitas Solutions. You can find your specific MAC by using the “Medicare Administrative Contractor Lookup” tool on the CMS website.

Key Services Noridian Provides to Beneficiaries and Providers

For Medicare beneficiaries, Noridian’s main functions include:

  • Processing Medicare Part A and Part B claims and issuing Medicare Summary Notices (MSNs) – typically every 3 months.
  • Handling appeals for denied or partially paid claims (first-level redeterminations).
  • Providing customer service via phone and online for questions about coverage, billing, and fraud concerns.
  • Issuing Medicare cards and replacement cards (though this is now centralized through CMS).

For providers (doctors, hospitals, labs, etc.), Noridian offers:

  • Provider enrollment and revalidation services.
  • Education on coding, billing, and Medicare coverage policies.
  • Processing of electronic and paper claims, with typical payment timelines of 14–30 days for electronic submissions.
  • Medical review and audit activities to ensure correct billing.

Noridian also operates a secure online portal called the Noridian Medicare Portal, where providers can check claim status, submit appeals, and access educational materials. Beneficiaries can use the Medicare.gov portal for most self-service tasks, but they can also call Noridian directly for claim-related questions.

Common Questions About Noridian and Medicare Claims

Many beneficiaries contact Noridian when they notice a claim was denied or paid less than expected. For example, if you receive a service that Medicare usually covers but the claim is denied, Noridian will send an MSN with a denial code. You have 120 days from the date of the MSN to request a redetermination (first-level appeal). Noridian’s customer service representatives can explain the reason for the denial and help you submit the correct documentation.

Another common issue is coordination of benefits. If you have both Medicare and another insurance (like employer coverage or a Medigap policy), Noridian will process the claim first if it’s the primary payer. If the other insurance is primary, Noridian will pay as secondary after receiving the primary payer’s explanation of benefits. Understanding this can prevent unexpected bills.

Noridian also handles claims for telehealth services, which have expanded under Medicare. If you receive a telehealth visit from a provider in a Noridian jurisdiction, the claim is processed under the same rules as in-person care, with some exceptions for originating site requirements.

How to Contact Noridian and What to Have Ready

If you need to reach Noridian about a claim, the best number to call is the one listed on your Medicare Summary Notice. Generally, the customer service line for Jurisdiction A beneficiaries is 1-877-567-7271, and for Jurisdiction D beneficiaries it is 1-877-567-7271 as well (though some states may have different numbers – always check your MSN). Hours are typically Monday through Friday, 8 a.m. to 8 p.m. Eastern time.

When you call, have your Medicare number (the number on your red, white, and blue card), the date of service, and the claim number from your MSN. For providers, the provider’s National Provider Identifier (NPI) and Tax Identification Number (TIN) are required. Noridian also offers a live chat option on its website for providers, but beneficiaries are encouraged to use the phone or Medicare.gov.

Frequently Asked Questions

Does Noridian handle Medicare Part C (Medicare Advantage) or Part D (prescription drug plans)?

No. Noridian only processes Original Medicare (Part A and Part B) claims. Medicare Advantage plans (Part C) and prescription drug plans (Part D) are administered by private insurance companies, not MACs. If you have a Medicare Advantage plan, you should contact that plan directly for claims and customer service.

How do I know if my state is in Noridian’s jurisdiction?

You can check your Medicare Summary Notice – it will list the MAC name. Alternatively, use the CMS “Medicare Administrative Contractor Lookup” tool online. Enter your ZIP code, and it will show your MAC for Part A, Part B, and DME. Most states in the Northeast and West are covered by Noridian, but there are exceptions (e.g., Texas and Florida are served by other MACs).

Can I appeal a Noridian claim decision online?

Yes. For first-level appeals (redeterminations), you can submit a request online through the Medicare appeals portal at Medicare.gov or by mailing a completed “Redetermination Request Form” to the address on your MSN. Noridian also accepts faxed appeals. For higher-level appeals (reconsideration by a Qualified Independent Contractor), you must use the standard process.

Closing Thoughts

Noridian Healthcare Solutions plays a critical behind-the-scenes role in making Original Medicare work for millions of beneficiaries across the United States. Whether you live in New York or Oregon, understanding that Noridian is the company processing your claims can save you time when you need to check on a payment or appeal a denial. Keep your Medicare card handy, review your MSNs carefully each quarter, and don’t hesitate to call Noridian if something looks off. A little knowledge about your MAC can go a long way toward making Medicare less confusing.