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Auxilary Aids & Services

For information about the availability of beneficiary auxiliary aids and services, please call our Beneficiary Contact Center at 800-833-4455.

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Railroad Medicare
Contacts for PTANs and EDI: Questions and Answers

The Railroad Medicare's Provider Enrollment (PE) telephone line is experiencing longer than average wait times and busy signals. In an effort to keep you from being delayed in receiving necessary information, we wanted to share some general questions we received on the PE telephone lines, along with those answers.

In addition to those general questions, we do receive inquiries about electronic billing (EDI) that cannot be answered on the PE lines. Those questions and answers are listed at the bottom of this article, as well as the contact number for our EDI department.

How do I establish a Railroad Medicare Provider Transaction Access Number (PTAN) if I am an electronic submitter
?
Change Request 3440 mandates that all providers submit claims electronically. Only providers that have been granted a waiver or meet exception qualifications are excluded. Before requesting a Railroad Medicare PTAN, you must first be enrolled with your local Medicare Administrative Contractor (MAC). Once you have provided a service to a Railroad Medicare beneficiary, then complete the
Railroad Medicare PTAN request form (PDF, 830 KB). You can fax this to (803) 382-2417.

How do I establish a Railroad Medicare PTAN if I am a paper submitter?
If you are waived from filing electronically, submitting the initial paper claim begins the process to obtain a PTAN. These paper claims must be sent to:

Palmetto GBA
Railroad Medicare
P.O. Box 10066
Augusta, GA 30999

Once a CMS-1500 claim form has been submitted to Railroad Medicare, we will issue a Railroad Medicare PTAN if your submission data matches what is on your local MAC's provider enrollment record. NOTE: Only the revised CMS 1500 (02/12) version claim form will be accepted effective April 1, 2014. Outdated CMS 1500 (08/05) version claim forms received on and after April 1, 2014 will be rejected as unprocessable.

Before you file a claim to Railroad Medicare, please be sure that the details on the CMS-1500 (02/12) claim form are consistent with what is on file with your local MAC. This includes the tax identification number (Item 25), billing name and billing address (Item 33). If the claim is incomplete or cannot be verified, we will send you a letter letting you know that the request cannot be completed at this time.

How long will it take for Railroad Medicare to issue a PTAN?
If everything matches, you will receive a welcome letter containing your Railroad PTAN number(s) within 60 days from the date we received your request.

I have a Railroad Medicare PTAN but need to update my record. How do I update with Railroad?
Once you have submitted the changes to your local MAC and have received confirmation of completion, you can send your changes to Railroad Medicare in writing to:

Palmetto GBA
Railroad Medicare
Provider Enrollment
P.O. Box 10066
Augusta, GA 30999

What if I lost my Railroad Medicare PTAN?
Please call 866-899-5227 or 888-355-9165 to receive this information. Be prepared to provide the legal business name, organization/group NPI, tax identification number and billing address information.

You may also write and request a listing of your PTANs. Include the legal business name, organization/group NPI, tax identification number and billing address information.

Palmetto GBA
Railroad Medicare
Provider Enrollment
P.O. Box 10066
Augusta, GA 30999

You can also fax this request to (803) 382-2415.

If you prefer to talk with a PE phone representative, the PE line at 866-899-5227 is available from 8:30 a.m. to 4:30 p.m. for all time zones except for PT, which receives service from 8 a.m. to 4 p.m. PT. You will need to supply the same verification data over the telephone as you do with a written request.

General Questions Regarding EDI
How do I enroll for electronic billing?
Our
EDI Enrollment packet is available online. If you need assistance completing the packet, contact our Technology Support Center at 866-749-4301.

Who do I call if there are problems with my electronic billing?
You can contact our Technology Support Center at 866-749-4301. For EDI, first press 3 for RRB, and then press 3 for EDI. Be prepared to provide the legal business name, organizational/group NPI and Railroad PTAN. 


 

last updated on 12/03/2014
ver 1.0.51