Can I request a reopening to remove a claim line?

The Centers for Medicare & Medicaid Services (CMS) established a reopenings process which allows providers to request simple corrections to claims. The CMS reopenings process does not permit adding or deleting lines from a claim. However, if you have billed a claim or a claim line(s) in error, Palmetto GBA Railroad Medicare can adjust the claim to reflect the billing error and recoup any funds paid in error, if needed. When the claim is reprocessed, the adjusted claim line(s) will be appear on your remittance advice with Claim Adjustment Reason Code (CARC) 112 – Service not furnished to the patient and/or not documented.

You can request a reopening by one of the following methods:

  • Call our Telephone Reopening line at 1-888-355-9165 Monday through Friday from 8:30 a.m. to 4:30 p.m. for all time zones, with the exception of Pacific Time, which receives service from 8 a.m. to 4 p.m. For reopenings, first press 4, and then to request a telephone reopening to correct minor errors or omission, press 0.
  • Submit a Reopening: Simple Claim Correction eForm through our eServices online portal
  • Submit a written reopening request by fax or mail

Fax your request to (803) 462-2218

or

Mail your request to:
Palmetto GBA Railroad Medicare
Attention: Appeals
P.O. Box 10066
Augusta, GA 30999 

A Reopening: Simple Claim Correction paper form is available on the Railroad Medicare Forms page. The form can be filled out online and then printed for submission.     

Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

Click to Chat Now