Medicare Blog

how to bill claims to railroad medicare

by Russ Luettgen Published 2 years ago Updated 1 year ago
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Getting Started With Railroad Medicare Billing Step 1: Ensure your enrollment information is correct with your local Part B Medicare Administrative Contractor... Step 2: Request a Railroad Medicare PTAN For electronic submitters: Request a PTAN using the Railroad Medicare PTAN... Step 3: Receive ...

You can either file electronic claims to Railroad Medicare through a clearinghouse or other third-party claims submitter, or you can submit paperless claims directly through Palmetto GBA's online provider portal eServices eClaims option.

Full Answer

Where to submit railroad Medicare claims?

• Call Palmetto GBA Railroad Medicare toll-free at 1-800-833-4455. If you are hearing impaired, you can call (877) 566-3572. • Call the Railroad Retirement Board’s automated system at 1-800-808-0772. • Submit an Online Service Request on the RRB website www.RRB.gov.

Does railroad Medicare accept paper claims?

Send paper claims to: Palmetto GBA Railroad Medicare. P.O. Box 10066. Augusta, GA 30999-0001. File an eClaim: eServices users also have the ability to submit paperless eClaims through the portal. See section 4.6 of the eServices User Manual (PDF, 8.59 MB) for more information. eServices Claim Submission (eClaim) Tips.

Does railroad Medicare require authorization?

Prior authorizations requests for Railroad Medicare patients should be submitted to the jurisdictional Medicare Administrative Contractor (MAC) that will process the hospital’s outpatient department facility claim. No PA requests should be submitted to Palmetto GBA Railroad Medicare.

Is railroad Medicare different than Medicare?

There is not much difference between Railroad Medicare and regular Medicare. The first difference is that Railroad Medicare is given to railroad retirement annuitants. This type if Medicare extends to their families as well. You will want to think of this Medicare as basically like receiving Social Security benefits upon retirement.

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How do you bill railroad Medicare?

Getting Started With Railroad Medicare BillingStep 1: Ensure your enrollment information is correct with your local Part B Medicare Administrative Contractor (MAC) ... Step 2: Request a Railroad Medicare PTAN. ... Step 3: Receive your Railroad Medicare PTAN. ... Step 4: File Electronically. ... Step 5: Go Green — Electronic Remits.

What is the EDI number for railroad Medicare?

The packet contains forms and explanations for each of the services offered by our Electronic Data Interchange (EDI) department. For further information regarding any of this material, please call the Railroad Medicare Provider Contact Center at 888-355-9165.

Does railroad Medicare follow Medicare guidelines?

(Although the age requirements for some unreduced railroad retirement benefits have risen just like the social security requirements, beneficiaries are still eligible for Medicare at age 65.)...Search.toll free:1-800-MEDICARE (1-800-633-4227)TTY/TDD:1-877-486-2048website:MEDICARE.govJan 14, 2022

Is railroad Medicare different from Medicare?

A: The only difference is that retired railroad beneficiaries have their Part B benefits administered by the Palmetto GBA Railroad Retirement Board Specialty Medicare Administrative Contractor (RRB SMAC) regardless of where they live. Members should be certain to advise providers of this when they receive treatment.

Will Railroad Medicare accept paper claims?

Only providers that meet the exceptions listed in CR 3440 can be granted a waiver to submit paper claims. You must have a Railroad Medicare PTAN before you can submit claims electronically to Railroad Medicare.

What do Railroad Medicare ID numbers look like?

Medicare Numbers have 11 characters and contain numbers and uppercase letters only. They do not contain the letters S, L, O, I, B or Z. Characters one, four, seven, 10 and 11 will always be a number. The second, fifth, eighth and ninth characters will always be a letter.

How do I check my railroad Medicare claims?

If you'd like to use the IVR, you can do so by calling 800–833–4455. From the main menu, press one (1) for claim status. You will need your Railroad Medicare number, date of birth, name, and date of service for the claim you are searching for. Claim status is available Monday thru Friday from 7 a.m. through 11 p.m. ET.

Does railroad Medicare accept corrected claims?

In the case where a minor error or omission is involved, you can request that Railroad Medicare reopen the claim so the error or omission can be corrected rather than going through the written appeals process. Reopenings may be submitted in written form, over the telephone or through our eServices online portal.

Is railroad Medicare an Advantage plan?

Yes, Railroad Medicare beneficiaries can choose to enroll in Medicare Advantage plans.

Who administers railroad Medicare?

As part of the retirement program, the RRB also has administrative responsibilities under the Social Security Act for certain benefit payments and railroad workers' Medicare coverage. In fiscal year 2021, the RRB paid retirement-survivor benefits of nearly $13.2 billion to about 519,000 beneficiaries.

What are railroad benefits?

The Railroad Retirement program was established in the 1930s. It provides retirement, survivor, unemployment, and sickness benefits to individuals who have spent a substantial portion of their career in railroad employment, as well as to these workers' families.

What is Medicare Part A?

Hospital Insurance ( Medicare Part A ), which helps pay for inpatient care in hospitals and skilled nursing facilities (following a hospital stay), some home health care services, and hospice care.

What is the enrollment period for Medicare?

Special Enrollment Period for People Covered Under a Group Health Plan#N#If you are age 65 or older and covered under a group health plan, either from your own or your spouse’s current employment, you have a special enrollment period in which to sign up for Medicare Part B. This means that you may delay enrolling in Medicare Part B without having to wait for a general enrollment period and paying the 10 percent premium surcharge for late enrollment. The special enrollment period rules allow you to: 1 enroll in Medicare Part B anytime while you are covered under the group health plan based on current employment; or 2 enroll in Medicare Part B during the 8-month period that begins the month after your group health coverage ends or employment ends, whichever comes first.

What is the RRB?

The Railroad Retirement Board (RRB) enrolls railroad retirement beneficiaries in the program, deducts Medicare premiums from monthly benefit payments, and assists in certain other ways.

What is the deductible for hospital care in 2021?

In 2021, the hospital insurance deductible amount is $1,484. If you receive medical services from a doctor, you pay a yearly deductible amount as well as a coinsurance amount for each visit. In 2021, the medical insurance deductible is $203.

What age does Medicare cover?

Medicare is our country’s health insurance program for people age 65 or older, certain people with disabilities who are under age 65, and people of any age who have permanent kidney failure.

How long does it take to enroll in medical insurance?

Initial Enrollment Period for Medical Insurance. When you first become eligible for hospital insurance (Part A), you have a 7-month period to sign up for medical insurance (Part B). This is called your initial enrollment period. A delay on your part may cause a delay in cover­age and result in higher premiums.

Can a spouse get Medicare if they are divorced?

Under certain conditions, your spouse, divorced spouse, surviving divorced spouse, widow (er), or a dependent parent may be eligible for Medicare hospital insurance based on your work record when he or she turns 65. Eligibility for family members under age 65.--.

How to contact RRB for Medicare debt?

If you are requesting to make a monthly installment payment, please contact the Railroad Retirement Board - Debt Recovery Section at +1 (312) 751-4514 or +1 (312) 751-4848.

Does Pay.gov send tracking ID?

However, if you provide your email address when paying your bill, Pay.gov will send you a payment confirmation email containing your Tracking ID, the amount paid, payment method, and other information you may wish to have for your records.

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