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Palmetto GBA to Process Part B Medicare Claims from North Carolina Providers

Columbia, S.C. – Palmetto GBA, the incoming A/B Medicare Administrative Contractor (MAC) for South Carolina, North Carolina, West Virginia and most of Virginia, is preparing to implement its North Carolina Part B workload and has developed a comprehensive communications plan to ensure a smooth transition for health care providers.

Physicians and other providers in North Carolina who currently submit Part B fee-for-service Medicare claims to CIGNA Government Services will begin submitting claims to Palmetto GBA on May 28, 2011. On that date, Palmetto GBA will assume responsibility for all Part B Medicare claims processing, customer service and payments. North Carolina’s hospitals and other Medicare Part A health care providers already submit their fee-for-service claims to Palmetto GBA.

Palmetto GBA will provide North Carolina Part B providers with detailed information about claims processing, appeals, Electronic Data Interchange (EDI), Electronic Funds Transfer (EFT), customer service, provider enrollment, Local Coverage Determinations, and ongoing provider outreach and education activities as the implementation date approaches. Providers can obtain current information and register for Palmetto GBA’s listserv communications at

Beginning May 28, North Carolina health care providers submitting Part B Medicare claims must include Palmetto GBA’s new payer identification number, which is 11502. Providers must also ensure they have signed an EFT agreement with Palmetto GBA to continue receiving electronic payments from Medicare.

Medicare beneficiaries with questions about coverage should continue to call 1-800-MEDICARE.

The Centers for Medicare & Medicaid Services (CMS) selected Palmetto GBA to serve as the A/B MAC for South Carolina, North Carolina, West Virginia and most of Virginia (Jurisdiction 11) in May 2010. Implementation for these states commenced in September 2010 and will be completed in June 2011. A complete implementation schedule is posted on Palmetto GBA’s Web site.

MACs are being implemented across the country to process claims for both Medicare Part A and B, replacing Fiscal Intermediaries that administered Part A and
Carriers that administered Part B. Part A Medicare helps cover fees from hospitals, skilled nursing facilities and other institutional providers. Part B covers fees from physicians, laboratories and other practitioners.

“We want to deliver clear and consistent information to the health care providers in North Carolina and throughout Jurisdiction 11 so there is no disruption in customer service or claims payments,” said Bruce Hughes, Palmetto GBA’s president and chief operating officer.

In Jurisdiction 11’s four states, more than 47,000 physicians and nearly 400 hospitals provide care to more than 3.6 million Medicare beneficiaries.


last updated on 04/29/2011
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