Top Time-Saving Tools for Palmetto GBA Providers

Published 03/24/2020

Are you aware that Palmetto GBA provides comprehensive tools to assist you in accomplishing a variety of tasks in order to save you time and streamline your processes? Calling our Provider Call Center (PCC) isn’t the only way to receive immediate assistance from Palmetto GBA.

Here are the top tools available to providers designed to streamline communication and enhance your productivity.

Function
Time-Saving Tips
Reason Codes
Preventing and knowing how to resolve Claim Submission Errors (CSEs) by understanding the reason codes will help expedite the processing of your claims and may save time and money. The CSE Help tool may assist you in your compliance efforts by providing information about how to resolve incorrect denials and avoid rejections.
Cost Reports

Need help with Cost Reports? Check out our Cost Reports guides and articles under the Audit and Reimbursement heading (JJ Part A, JM Part A, and Home Health and Hospice (HHH).

The MCR e-filing (MCReF) system is available for electronic transmission of cost reports. MCReF is the Medicare Cost Report eFiling system. The portal allows Medicare Part A providers to electronically transmit (eFile) their cost report and supporting documentation, directly to their Medicare Administrative Contractor (MAC). Providers may eFile reports with fiscal year end (FYE) dates on or after December 31, 2017 through MCReF.

Claim Status
If you have access to claims status and are successfully logged in, select the Claims tab. The claims status screen will appear. In addition to the other required fields, you must enter the patient's Medicare number and the date range of date of service for the claims you seek.
Credit Balance Reports
Need help with Credit Balance Reporting (CMS 838)? Check out our Credit Balance Reporting guides and articles under the Credit Balance Reporting heading.
Appeals
By using eServices, providers can electronically submit an appeal request and PDF attachments online. Once submitted, you will receive a confirmation from Palmetto GBA indicating that the appeal has been received.
Provider Enrollment

Palmetto GBA providers can access the status of Medicare enrollment applications through use of two self-service tools — the Interactive Voice Response System (IVR) and the Palmetto GBA website. Both methods can be achieved in a few simple steps. To check the status of your application via:

Palmetto GBA website: Please visit the website for your contract and line of business (LOB):

Interactive Voice Response (IVR):
  • Locate the IVR Call Flowchart located under the Resources tab on the Palmetto GBA website
  • Select the link for Call Flowchart and follow the prompts for Provider Enrollment Application Status Tool
Online Remittances
Palmetto GBA is pleased to offer secure and fast access to your Medicare online remittances through our eServices.
Financial Tools

You may use the Financial Tools tab to inquire about your payment floor status and last three checks paid. You will only be able to view financial information for the PTAN associated with the eServices user ID you are logged in under, or the PTAN selected if you have multiple accounts linked to your user ID.

If you have been granted permission, you will see the Financial Forms subtab. You can access finance related forms such as eCheck and eOffset from this subtab. Please keep in mind that certain forms may only be available for specific lines of business.
Webchat/eChat
Secure Web Chat
Web chat is one of the web-based tools offered by Palmetto GBA. This innovative feature allows providers the ability to interact with designated Palmetto GBA staff so they can receive real-time assistance in locating information on the Palmetto GBA website. Users can dialogue with an online operator who will provide help locating information on any topic. During Web chat hours of operation, providers will receive a popup notification asking if a provider would like to chat.
 
eChat
This feature provides real-time interaction with designated Palmetto GBA staff on any topics or specialties they are searching for on either the Palmetto GBA website or within the eServices online portal. The Secure eChat feature also allows users to dialogue with an online operator who can assist with patient- or provider-specific inquires, or address questions that require the sharing of PHI information.
  • Once in the eServices portal, from the bottom right corner select either Medicare Inquiries or eServices Help
Submitting Level 2 Appeals
C2C Innovative Solutions, Inc. (C2C), the Part A East QIC, is currently offering providers telephone discussions and reopenings under this Medicare Appeals Demonstration. This demonstration allows providers the valuable opportunity to engage in a telephone discussion with the QIC’s medical reviewer prior to their decision being rendered; or, it allows the provider its last opportunity to submit documentation for appeals that are pending a hearing at the Office of Medicare Hearings and Appeals (OMHA).
Looking for Medicare Coverage Information?

The Medicare Coverage Database (MCD) contains all National Coverage Documents, Local Coverage Determinations (LCDs) and articles. The MCD offers multiple ways to locate and view data:

Document ID Search — Provides users the ability to search both the NCD and LCD databases using the document ID. The search button appears on the right-hand side of the screen.

  • Advanced Search — Provides users with additional filters to narrow the search

  • Indexes — Provides users with pre-defined lists of national and local coverage documents

  • Reports — Provides users with reports of national and local coverage data

  • Downloads — Allows users to download complete sets of LCDs and articles and the complete set of NCDs

Use this link for quick access: JJ Part A

 

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