New Year: Identify Beneficiary Insurance Changes For 2022

Providers are reminded that a new year means patients may have made changes to their Medicare coverage. Ask patients about insurance coverage changes and for a copy of their most recent Medicare card. If a patient has a Medicare Advantage Plan or is a Railroad Medicare beneficiary, you must file the Medicare claim to the correct insurer. Use the information on a patient’s Medicare Advantage Plan card to identify the insurer and direct claims and questions to that plan. Failure to submit claims to the correct insurer delays payment and creates additional workload for providers and Medicare Administrative Contractors.

Railroad Medicare beneficiaries have a red, white, and blue Medicare card that includes the Railroad Retirement Board logo and “Railroad Retirement Board” in the red banner at the bottom of the card. Railroad Medicare beneficiary claims should not be included in your file of Original Medicare claims that are submitted to Palmetto GBA Jurisdiction J or M. Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC), but claims and inquiries for Railroad Medicare beneficiaries must be directed to and handled by the RRB SMAC, which is a separate contract.

Providers may use the Palmetto GBA eServices portal as a fast and easy way to verify Medicare eligibility. The eServices User Manual (PDF) is available under the “Need Help” link on the portal’s login webpage. 

Medicare beneficiaries with questions about their Medicare plan or eligibility may call the dedicated Medicare Beneficiary Call Center at 1-800-MEDICARE.