NOTICE OF MEDICARE NON-COVERAGE (NOMNC) …
EDRC1997. 072023
Notice of Medicare Non-Coverage (NOMNC) Training
Updated 7/21/23
? 2023 CareCentrix, Inc. All rights reserved. Confidential and Proprietary.
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NOMNC Overview
In this training presentation we will cover the following topics:
? What is a Notice of Medicare Non-Coverage (NOMNC)? ? When should a patient covered under a Medicare Advantage or
Dual Eligible Special Needs Plan (D-SNP) receive a NOMNC? ? Which CareCentrix customers have Medicare Advantage and/or
D-SNP members? ? Where are NOMNC forms, instructions, and other tools located? ? How should a provider complete a NOMNC? ? What are some common NOMNC Do's and Don'ts?
? 2023 CareCentrix, Inc. All rights reserved. Confidential and Proprietary.
2
What is a NOMNC?
A NOMNC is a Centers for Medicare and Medicaid Services (CMS) approved form that a provider must deliver to a patient covered under a Medicare Advantage or D-SNP plan who is receiving covered skilled services, such as Home Health Agency (HHA), Skilled Nursing Facility (SNF), and Comprehensive Outpatient Rehabilitations Facility (CORF) services, when services are terminating in certain situations.
? 2023 CareCentrix, Inc. All rights reserved. Confidential and Proprietary.
3
NOMNC Key Points
1) The NOMNC notifies a patient covered under a Medicare Advantage or D-SNP plan in writing that the patient's health plan and/or provider have decided to terminate the patient's covered HHA, SNF or CORF care and, as a result of the termination of services, the patient has appeal rights.
2) The provider must deliver the NOMNC to the patient unless a NOMNC exception applies.
3) The NOMNC must be fully completed consistent with the CMS NOMNC instructions.
4) The NOMNC must be delivered to the patient at least two (2) calendar days before covered services end OR the second to last day of service is care is NOT being provided daily.
5) The provider should, at no cost, fulfill a patient's special accommodation request including providing a NOMNC in large print and alternate languages as required by CMS.
? 2023 CareCentrix, Inc. All rights reserved. Confidential and Proprietary.
4
NOMNC Key Points
These NOMNC requirements apply to the following CareCentrix health plan customers with Medicare Advantage and D-SNP members: Florida Blue, Horizon, Wellcare and Blue Cross Blue Shield of Michigan.
1) Providers can see which patients are covered by a Medicare Advantage or D-SNP plan by looking at the patient's insurance ID card or the Service Registration Form (SRF) issued by CareCentrix.
2) The CMS NOMNC template and instructions are available on the CMS Website.
? CMS' Form Number is 10123 (Approved 12/31/2011) OMB approval (09380953)
? NOMNC instructions and forms with Florida Blue plan specific contact information pre-populated are located on the HomeBridge? provider portal. For Providers Resources and Forms Health Plan Forms
? 2023 CareCentrix, Inc. All rights reserved. Confidential and Proprietary.
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