How does Medicare work for railroad employees?
Medicare offers coverage to railroad employees just as it does for people who have Social Security. The payroll taxes of railroad employees include railroad retirement and Medicare hospital insurance taxes.
Which Macs process Medicare and railroad Medicare claims?
Home Health and Hospice — The four A/B MACs that process jurisdictional home health and hospice (HHH) claims process those claims for both Medicare and Railroad Medicare beneficiaries. You can use the CMS MAC Website List to find your local HHH MAC.
How do I enroll for electronic claims with railroad Medicare?
Before filing claims electronically to Railroad Medicare, you must have an EDI enrollment packet on file with Palmetto GBA. See our Electronic Data Interchange (EDI) resources for more information on enrolling for electronic claim submissions.
What is the fax number for Medicare for railroad Medicare?
Fax 532 (invoice) and 733 (opt out providers) ADS Letters to: (803) 264-0697 Railroad Medicare does not accept CMS-1500 claim forms via fax. View our main Contact Us page for information on how to submit a general inquiry or to contact a different department.
Where do I file a railroad Medicare claim?
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.
Who administers railroad Medicare?
Palmetto GBA is contracted by the independent federal agency Railroad Retirement Board (RRB), which administers comprehensive retirement-survivor and unemployment-sickness benefit programs for railroad workers and their families under the Railroad Retirement and Railroad Unemployment Insurance Acts.
What is railroad Medicare payer?
Payer Name: Medicare - Railroad|Payer ID: MR018|Professional (CMS 1500)
Is there a difference between Medicare and railroad 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.
Does railroad Medicare have a provider portal?
Events. Palmetto GBA Railroad Medicare is pleased to offer eServices, our free Internet-based, provider self-service portal. The application provides information access over the Web for the following online services: Eligibility.
How do I contact railroad Medicare?
Provider Contact Center: 888-355-9165 Representatives are available Monday through Friday from 8:30 a.m. to 4:30 p.m. for all time zones with the exception of PT, which provides service from 8 a.m. to 4 p.m.
How do I bill Railroad Medicare claims?
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.
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.
Can you submit paper claims to railroad Medicare?
SUBMITTING CLAIMS ELECTRONICALLY The Administrative Simplification Compliance Act (ASCA) prohibits Medicare coverage of claims submitted to Medicare on paper, except in limited situations. All initial claims for reimbursement from Medicare must be submitted electronically with limited exceptions.
Is railroad Medicare a Medicare Advantage Plan?
Yes, Railroad Medicare beneficiaries can choose to enroll in Medicare Advantage plans.
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.
What is RRB beneficiary?
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.
Is railroad Medicare a Medicare Advantage Plan?
Yes, Railroad Medicare beneficiaries can choose to enroll in Medicare Advantage plans.
How do I bill railroad Medicare claims?
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.
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.
What does a railroad Medicare number look like?
It will contain capital letters (all letters with the exception of S, L, O, I, B and Z) and numbers (0-9). The 2nd, 5th, 8th, and 9th characters will always be a letter, while characters 1, 4, 7, 10, and 11 will always be a number. The 3rd and 6th characters will be a letter or a number.
How long does it take for Medicare to reject a claim?
Rejected claims must be corrected and resubmitted no later than 12 months from the date of service. Medicare will deny claims received after the deadline date.
How long does it take to file a claim with the MAC?
Claims must be filed to the appropriate MAC no later than 12 months, one calendar year, from the date of service. Timely filing is determined by the date a processable claim is received by the appropriate MAC.
Call 888-355-9165, select Option 5 for Customer Service
Representatives are available Monday through Friday from 8:30 a.m. to 4:30 p.m. for all time zones with the exception of PT, which receives service from 8 a.m. to 4 p.m.
Contact a Different Department
View our main Contact Us page for information on how to submit a general inquiry or to contact a different department.
Where is the railroad retirement board on my Medicare card?
Your Medicare card is similar to the new Medicare cards that all beneficiaries receive, with the exception that “Railroad Retirement Board” is printed in a red banner at the bottom of the card .
What happens if you receive a railroad retirement?
If you receive Railroad Retirement benefits or disability annuity benefits from the railroad at the time of eligibility for Medicare, you are automatically enrolled in Medicare Parts A and B by the RRB. After the RRB automatically enrolls you, you receive your Medicare card together with a letter from the RRB explaining ...
What is the RRB?
The RRB administers insurance and retirement benefits to all railroad workers in the country. Instead of getting retirement benefits from the U.S. Social Security Administration as other workers do, the RRB provides railroad workers and their families with retirement benefits, along with unemployment and sickness benefits, ...
Do you have to go through the Social Security Administration if you are employed by the railroad?
However, if you have end-stage renal disease (ESRD) and qualify for Medicare, you must go through the Social Security Administration even if you are employed by the railroad.
Does Medicare cover railroad employees?
Medicare offers coverage to railroad employees just as it does for people who have Social Security. The payroll taxes of railroad employees include railroad retirement and Medicare hospital insurance taxes.
When can I disenroll from Medicare Advantage?
A: You can generally disenroll from a Medicare Advantage plan only during the Medicare open enrollment period of October 15-December 7, the Medicare Advantage Plan disenrollment period of January 1-February 14, or when you qualify for a Special Enrollment Period (SEP). For more information on SEPs, go to www.Medicare.gov.
What is the difference between Medicare Part B and Medicare Part B?
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. Also, be sure to provide your Railroad Medicare card at time of service as the information on the card identifies you as a Railroad Medicare beneficiary to the provider.
Does Medicare cover dental implants?
A: In most cases, Medicare does not cover dental services, specifically, services related to the care, treatment, filling, removal, or replacement of teeth, or structures directly supporting teeth. This would include check-ups, cleanings, and dental devices (such as dentures, dental plates, dental implants, or bridges) as well as extractions or other procedures performed to prepare the mouth for dentures (including reconstruction of the ridge) or titanium implants.
Does Medicare cover injectable cancer drugs?
A: Only in limited instances will Medicare Part B provide for prescription drug coverage, such as for certain injectable cancer drugs or immunosuppressive drugs. All other Medicare benefits for prescription drugs require enrollment in a Part D Prescription Drug Program.
Do I need to sign up for Medicare Part B?
A: As an active employee covered under the active employee H&W Plan, you do not need to sign up for Medicare Part B. You should, however, sign up for Medicare Part A (for which there is no cost) to avoid any future Medicare enrollment problems. It is strongly recommended that you contact the Railroad Retirement Board three (3) months before you turn age 65 to start the Medicare enrollment process.
Can Medicare cards be similar?
A: This can easily happen as the two Medicare cards are very similar. The doctor’s office should pay close attention to the specific details printed on your Railroad Medicare card.
Does Medicare pay for hearing aids?
A: No, Medicare does not pay for hearing aids or hearing exams, when the purpose of the exam is to determine whether you need hearing aids or for fitting hearing aids.
