As claims conclude, ERA files will become available to download through the Claim Submission/ERA option. For access to the ERA, click Claim Submission/ERA and click File Status and Reports. Select the 835 files and download them to the folder/location you specify.
After sixty days, remittances can be requested in Novitasphere by clicking on the Remittance Advice link in the Claims Info section.
Novitasphere Login Guidelines
The step-by-step guide below can help you log in to Novitasphere.
Step 1: Visit the official PortalPortal of Novitashpere at: https://www.novitas-solutions.com/.
Step 2: Click on the “User Sign-In” button under the dropdown menu at “Novitasphere portal” on the left side of the website.
Step 3: Enter the username you created while registering at the website.
Step 4: Enter the password you created while registering at the website.
Step 5: Click on “Agree to the Terms & Conditions.”
Step 6: Click on the green color “sign-in” button to get yourself logged in.
To Access the Novitasphere website.
- Novitasphere login web address.
- To log in to Novitasphere Provider Portal, you need a valid username and password.
- You must be running Microsoft Edge, Google Chrome, Apple Safari, or Mozilla Firefox.
- Have a reliable internet connection on your PC, laptop, smartphone, or tablet.
Medicare Novitasphere Medicare Registration Guidelines
To register yourself at Novitasphere, one should follow the guidelines given below.
- Enter your details, i.e., First name, Middle name, Suffix, Date Of Birth, Email Address, Confirm Email Address.
- Enter your Contact details.
- Set up your credentials, i.e., Username and Password.
- Click “Register” to get yourself registered at Novita sphere.
Novitasphere Enrollment Steps For Providers And Facilities
Step 1 – Fill out the Novitasphere Login Portal Enrollment Form.
Step 2 – Request for access from the provider’s office.
Step 3 – Provider Office Back-Up Approver Access Request.
Step 4 – All Other Staff (End User) Access Request.
Step 5 – Provider Office Approver/ Provider Office Back-Up Approver Review End User Requests.
Enrollment steps for Billing Services & Clearinghouses with Novitasphere
Step 1 – Fill out the Novitasphere Provider Portal Third-Party Portal Enrollment Form
Step 2 – Billing Office Approver Access Request
Step 3 – Billing Office Back-Up Approver and End User Access Request
Step 4 – Billing Office Approver/ Billing Office Back-Up Approver Approve End User Access Request
Step 5 – Link Providers
The Novitasphere Portal Enrollment form must be filled out if you did not complete the Novita sphere Portal Migration List Template. When you submit your Third Party Novitasphere Portal Enrollment Form, a new Novita sphere submitter ID will be emailed to you.
Novitasphere Features and Functionality
- Obtain information regarding the status of appeals, including the outcome of the request.
- Obtain account receivable details, including recoupment, adjustment, collection amounts, and duplicate demand letters.
- Report entire paid claims, or individual paid lines of a claim, as billed in error.
- Make corrections to claims that include the number of services or units, diagnosis codes and procedure codes, specific history corrections, and much more.
- Obtain information for how many claims and dollars are in specific status locations.
- Obtain the status of a claim accepted into the claim processing system.
- View claim summary information per provider, such as the number of claims approved to process, claims pending, and more.
Search & Status Lookup Tools: These tools provide instant results with minimal input from you. Quickly check the status of an application, inquiry, or locate a policy in seconds.
Online Electronic Submission Tools: Avoid the wait and submit your claims, medical records, and other correspondence electronically.
Gateways: Gateways allow you to submit popular transactions on the web for free, with no enrollment required.
Fiscal Intermediary Shared System (FISS)
Federal Intermediary Shared System (FISS) is the Medicare Part A claims processing system managed by the CMS that allows claim submission via Direct Data Entry (DDE), eligibility, financial information, reports, and other inquiry tools to be accessed.
The application allows you to check the status of first-level appeals (redetermination requests) and determine whether they are being reviewed or finalized. Note: The tool does not allow you to view the appeal’s decision or allow you to view any individual patient details.
CERT (Comprehensive Error Rate Testing) Program
The Centers created this federally mandated program integrity activity for Medicare and Medicaid Services (CMS) to ensure that Medicare claims are billed and paid accurately. Here are some error rates calculated using this program:
- Contractor specific
- Contractor type
- Provider type
- Service type
By extracting data and producing rates, CMS and its Medicare Administrative Contractors (MACs) have valuable information about the sources of errors that can be used for preventing billing, payment, and processing errors. Also, CMS utilizes the CERT error rates in measuring progress toward its performance goals.
CERT is governed by the Improper Payments Elimination and Recovery Improvement Act of 2012. As the legislation states, “The heads of federal agencies, including HHS, are required to review programs that they administer annually to improve efforts to reduce and recover improper payments.” “CMS and Contractors analyze improper payment rate data and develop plans to reduce improper payments.” Stated, the objective of the CERT program is to reduce improper payments through educational efforts and thereby reduce CERT error rates.
AdvanceMed, the CERT Review Contractor, selects random samples from each Medicare claims to process the contractor to ensure the medical integrity of the claims. As part of the CERT Review Contractor’s process, each claim selection is accompanied by request for medical records from the provider or supplier who submitted the claim (different follow-up requests may be made depending on the response or non-response).
Additional documentation requests are made to the client who ordered the service or item. CERT evaluates a statistically valid random sample of claims based on the medical record documentation to determine whether they were properly coded and billed under Medicare regulations. The wrongful billing, payment, or claims processing is considered a claim error.
How to regain access to Novitasphere Login following the removal of your role due to inactivity
If Novitasphere was removed from a user’s IDM User ID because of inactivity, the user must follow these steps to request the Novitasphere MBI Lookup Tool Application role and relink to their organization.
- Go to the Identity Management (IDM) website.
- Click the button to agree to the Terms & Conditions after entering the User ID and Password you just created.
- Click Sign In.
(If you have difficulty logging into your account, contact the Novitasphere Login Portal Help Desk at 1-855-880-8424.)
- Choose your Multi-Factor Authentication (MFA) device, enter the security code received, and click Verify.
- Select “Role Request.”
- You can either scroll through the dropdown menu or type Novitasphere Provider Portal in the box to filter the applications.
- Choose the role you held before being inactively removed.
(Provider Office Approvers will select the “Provider Office Approver” role from the dropdown. The billing service/clearinghouse approver will select “Billing Office Approver” from the dropdown list.)
- Click “Associate with an existing organization.” Identify your organization’s legal name and its state. Press the Search button.
(To locate your organization, we suggest using only the first word of the Legal Business Name.)
- For a list of your search findings, click the dropdown arrow in the Organization field. Make sure you choose the correct organization.
- Ensure that all registration information is complete and accurate. We recommend printing the “Request New Application Access Review” page for your records. You can make changes by selecting “Back” and making any necessary corrections.
- Please enter the reason for requesting Novitasphere Login access in the Reason for Request box. Suppose you would like access to Novitasphere MBI Lookup Tool. Please include the tax ID number for which you are requesting access; this will allow us to process your request more quickly. Click Submit Role Request.
- Your tracking number will be shown on the confirmation page of the role request. If you wish, you can write this down or print it and keep it in a safe place for future reference. The pending request information can also be viewed under My Requests.
- Once your request has been processed, you will receive an email notification. The Office Approver/Office Backup Approver will need to review the appeal of end-users. If approved, the email will say “approved” and provide additional information regarding the user of Novitasphere.
- If rejected, the email will say “rejected” and give the reason. Complete the steps for requesting Novita sphere role access again with the necessary corrections.
- Once approved, access Novitasphere at https://www.novitasphere.com.
Reset Credentials At Novitasphere Provider Portal
To reset the Username at Novitasphere, visit the official Login page of Novitasphere, click the “Forget Username & Password link,” and follow the steps given below.
- Enter Email Address.
- Enter First Name.
- Enter your Last Name.
- Enter Your Date Of Birth.
- Enter your Zip Code.
To reset the password at Novitasphere, enter the User ID and select Reset via Email, SMS, or Voice call.
Frequently Asked Questions
In Novitasphere, why is it impossible to tab between fields?
Those using the Firefox browser will be unable to use the “Tab” key to move between fields in Novitasphere.
What is the purpose of a new submitter ID?
A new submitter ID is necessary due to updates to the Novitas Solutions EDI systems. It is not possible for customers to enroll for access to the Novita sphere in the IDM system until their enrollment form has been processed and the new submitter ID assigned. Unless this point is completed, IDM access requests will be rejected.
What are the steps to gaining access to Novitasphere for the additional staff?
It is the responsibility of each user to request access. IDM and register them as Office Back-Up Approver or End Users, as appropriate. The Novitas staff will review Office Back-Up Approver requests. In a user request, an email will be sent to the Office Approver indicating that the application is waiting for approval. They will need to log into IDM and approve the request.
My eligibility inquiry was rejected because a message stated that an error had occurred. What action should I take?
You will receive notifications about planned maintenance via our Alerts & Updates feature. Ensure that the criteria for your search have been entered correctly. The HIPAA Eligibility Transaction System (HETS) also requires periodic maintenance. The Alerts & Updates feature will inform the user about planned maintenance. An error message will be displayed if there is an unexpected system failure. Therefore, users should seek information from an alternative source until the HETS connection is restored.
What changes do I need to make to submit claims through Novitasphere?
When you receive a new submitter ID, you will need to update your billing software so that you can claim the PortalPortal. For instructions on how to complete this update, please consult your billing software. You can find information about updating PC-ACE software in the PC-ACE User Quick Steps.
How to Contact Novitasphere?
For questions about enrollment, password resets, or usage, please contact the Novitasphere Help desk at 1-855-880-8424 from 8:00 AM – 5:00 PM Eastern Time (ET), 7:00 AM – 4:00 PM Central Time (CT). Please have your Provider Transaction Access Number (PTAN), National Provider Identifier (NPI), and Tax ID for Novita sphere available when calling.