Palmetto GBA
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West Virginia Part B Carrier

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E-mail Contacts:
E-mail Palmetto GBA with your questions. Choose the topic that best describes your inquiry, then send us your question (please do not include any Protected Health Information). Note: We respond to inquiries in the order in which we receive them. Please allow us time to research your question in order to provide you with the best possible service.
 
Telephone Contacts:

Provider Inquiries
Hours of Operation
(Monday-Friday, EST unless otherwise noted)
Contact Number
Provider Contact Center (PCC)
Call the PCC for issues related to claims, billing, eligibility, provider education and other provider issues.
 8:30 a.m. - 4:30 p.m.
CSRs: (866) 332-7025
Fax: (614) 473-6805
Interactive Voice Response (IVR) System
Call the IVR System for claim status, to order copies of the Standard Provider Remittance (SPR), eligibility inquiries, etc.

See
IVR Users’ Guide for helpful tips on using this system
 Patient eligibility and claim status:
6 a.m. - 9 p.m.
 
Other transactions: 24 hours/
7 days a week
(877) 567-9232
Telephone corrections
Call for corrections to submitted claims ('telephone reopenings')

Note: Restrictions apply
9 a.m. - 12 p.m.
and 1 p.m. - 3 p.m.
(866) 308-5441
Technical assistance with electronic billing, Electronic Remittance Advice (ERA), and other EDI issues
7:30 a.m. - 12 p.m.
1 p.m. - 4:30 p.m.
(866) 308-5438
Fax: (614) 473-6802
To fax electronic claim documentation
 
Fax: (803) 264-7708
Provider Enrollment
Assistance with Provider Enrollment, including completion of the CMS 855 applications.
8 a.m. - 4 p.m.
(866) 308-5439
Fax: (614) 473-6811
Provider Outreach & Education
Requests for workshops or meetings
24 hours/
7 days a week
(877) 567-9232
(Select Option 3, then Option 7)
Beneficiary Inquiries
All questions related to the Medicare program.
24 hours/
7 days a week
1-800-MEDICARE
((800) 633-4227)
Fraud and Abuse Hotline
To report or ask questions regarding fraud and/or abuse.
8 a.m. - 4 p.m.
(888) 619-5316

Written Correspondence Contact Information:
 
Physical address:
Palmetto GBA
4249 Easton Way
Columbus, OH  43219
 
Department Specific Mailing Addresses:

Department
P.O. Box
Zip Code
All paper claims including Medicare Secondary Payer (MSP) claims
182932
43218-2932
General Inquiries

General coverage and Medicare-related questions
  • Crossover questions
  • Questions regarding claim filing requirements
  • Explanation of denial reasons
  • IVR resources
  • Medicare Secondary Payer (MSP) resources
  • Modifier guidelines
  • Medical record documentation questions
182933
43218-2933
Redeterminations (first-level appeals)
182933
43218-2933
MSP reviews and correspondence
  • Receipt of two primary payments
  • How to update a beneficiary’s primary/secondary record
182933
43218-2933
Provider Enrollment
  • Enrollment (credentialing) questions
  • Request CMS-855 B, I or R forms
  • Change address, add a location, add a new member to a provider group
  • Independent Diagnostic Testing Facility (IDTF) enrollment
  • Electronic Funds Transfer (EFT) CMS 588 form
  • Medicare Participating Physician or Supplier Agreement (PAR) CMS 460 form
  • How to obtain a National Provider Identifier (NPI)
  • Participation corrections
  • IRS 1099 tax form corrections
  • Consent Forms
182933
43218-2933
Responses to our requests for information ('automated development requests')
182933
43218-2933
Responses to our requests for medical records
182935
43218-2935
Financial correspondence with/without checks
182934
43218-2934

Disclosure

  • Requests for Medicare guidelines or coverage issues
  • Requests for hardcopy (paper) fee schedule information
  • Medicare pricing for services not included in the fee schedules
182934
43218-2934

Freedom of Information Coordinator:

Dale D. Bates
Disclosure / Freedom of Information Act
Medicare Part B Administration
Ohio and West Virginia
Palmetto GBA, L.L.C.
4249 Easton Way, QA-520
Columbus, OH 43219

All requests must contain your complete signature.
 

   
Electronic Data Interchange (EDI)
  • EDI enrollment and other EDI-related issues
  • Administrative Simplification and Compliance Act (ASCA)
  • Electronic Remittance Advice (ERA)
  • Medicare Remit Easy Print (MREP)
  • PC-Ace Pro 32 (Billing Software)
  • EDI Tests
182934
43218-2934
Limiting Charges
182934
43218-2934
To report suspected fraud
182935
43218-2935

Still Have Questions?

  • You can find direct answers to your technical questions by visiting our Site Help page
  • Need to contact another Medicare department on this site? Go to our Site Contact page.
  • For help with technical problems using your computer on this Web site, e-mail Palmetto GBA's Technical Assistance
  • How are we doing? Contact the Centers for Medicare & Medicaid Services (CMS) POE Coordinator in writing about Palmetto GBA's service. Their mailing address is: 

    Patrick Hamilton
    Health Insurance Specialist, Provider Services Branch 
    The Centers for Medicare & Medicaid Services, Region III
    150 S. Independence Mall W.
    Philadelphia, PA 19106-3499

 

last updated on 07/17/2008
CMS