If you have recently provided a Part B service to a Railroad Medicare beneficiary and are ready to submit your claim, follow these six easy steps to start billing:
Step 1: Ensure your information is correct
Make sure your enrollment information is current with your local Part B Medicare Administrative Contractor (MAC). Because Medicare law mandates that Railroad Medicare’s provider enrollment records directly match what your local MAC has on file, you must be sure that your data is correct before contacting Railroad Medicare to request a Medicare Provider Transaction Access Number (PTAN).
Step 2: Request a Railroad Medicare PTAN
For electronic submitters: You can complete the Request for Railroad PTAN for Electronic Billers form and fax it to (803) 382-2417. Or, you can mail it to:
P.O. Box 10066
Augusta, GA 30999-0001
To request a PTAN by telephone, call 866-899-5227. Please be ready with the following information:
- Provider’s Legal Business Name
- National Provider Identifier (NPI)
- Organizational/group NPI
- Provider’s complete name
- Tax Identification number (TIN)
- Billing address
- Practice address
If the information you provide does not match what your local MAC has on its enrollment file, Railroad Medicare will not be able to proceed with your request at that time.
For paper submitters:
If you have received a waiver from filing electronically from your local MAC, you can submit your initial paper claim(s) to obtain a Railroad Medicare PTAN.
Once a CMS-1500 (08-05) form is received by Railroad Medicare, we will obtain your enrollment data from your local MAC and issue you a Railroad Medicare PTAN if everything can be verified on the MAC’s file, including the TIN (item 25), billing name and billing address (item 33). If the claim documentation is incomplete or cannot be verified, you will receive a letter stating that your request cannot be completed.
Step 3: Receive your Railroad Medicare PTAN
After we authenticate your information with the local MAC’s provider enrollment file, we will send you a letter detailing your Railroad Medicare PTAN data.
Step 4: File Electronically
Though waivers can be granted for good cause, the Centers for Medicare and Medicaid (CMS) strongly advises all providers to file electronically. To do so, please visit the Electronic Data Interchange (EDI) portion of our website at www.PalmettoGBA.com/rr and download our 'Railroad Medicare EDI Enrollment Packet.'
Step 5: Go Green: Electronic Remits
Electronic Remittances can be requested by selecting the appropriate box on the Railroad Medicare Part B EDI application. The Centers for Medicare & Medicaid Services (CMS) has made available the Medicare Remittance Easy Print (MREP) software that allows you to view and print 835 Electronic Remittance Advices. If you requested a receiver ID, you may click the download form for MREP Software to install. If you are using a clearinghouse/billing service to receive your electronic remittances, please contact the clearinghouse/billing service for assistance. For technical assistance, please contact the Palmetto GBA EDI Technology Support Center at 866-749-4301.
Step 6: Get Paid Electronically
It’s faster and cheaper, and Medicare regulations require payments be received through electronic funds transfer (EFT). If you are newly enrolled in the Railroad Medicare program or making changes to your existing enrollment records, you will begin receiving EFT payments for claim payments. EFT allows a financial institution to deposit Railroad Medicare payments directly into a designated account. Once you have been established to receive funds EFT, you will be no longer eligible to receive your Railroad Medicare payments via paper checks.
If you have any questions along the way, please call our Provider Contact Center at 888-355-9165. Representatives are available from 8:30 a.m. to 4:30 p.m. in all time zones with the exception of PT, which receives service from 8 a.m. to 4 p.m. PT.