How will we be notified of the review decision?

Answer
If the CERT contractor determines that the claim was processed correctly, no notification occurs. If the CERT contractor's decision is to pay, deny, partially deny, down-code or up-code the claim, the CERT contractor notifies Palmetto GBA of the decision. Palmetto GBA will make adjustments to the previous reimbursement, and if the overpayment is greater than $10, we will notify you in writing to request a refund. The provider will also receive a CERT Error letter from Palmetto GBA to explain the specific reason for assessing the error.

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

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