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
Provider Enrollment

Palmetto GBA providers can access the status of Medicare enrollment applications through use of two self-service tools — 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
Appeals
First Level Redeterminations: Using eServices for the submission of first level appeals saves time and money!
Providers are encouraged to submit their appeals via Palmetto GBA's eServices portal. By using eServices, providers can submit the appeal request and the complete medical record online

Once an appeal has been submitted, you are able to check the status with a few quick clicks by utilizing the Redetermination Status Tool.

The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed.

  • To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for the claim you appealed
Claims Status
If you have access to claims status and are successfully logged in, click on 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.
Webchat / eChat

Need a Quick Answer to A Medicare Question? Consider Our Free and Simple Secure Chat Features
Palmetto GBA offers two ways providers can securely engage in electronic chats with our customers, eChat and webchat.

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

Webchat
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
Electronic Payments

Palmetto GBA offers immediate offset requests and electronic payments for Medicare overpayments and voluntary refunds in eServices.

  • Access the Financial Forms subtab to submit immediate offset requests for Medicare overpayments, or eCheck electronic payments for Medicare overpayments and voluntary refunds online
  • Just select the desired form from the dropdown menu and the form link will display at the bottom of your screen. Click on the form link and complete the form. You may attach PDFs up to 40 MB each in size. The total size of all attachments cannot exceed 150 MB. 
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.
Re-Openings
Providers can use this form located under the Forms tab of our eServices portal to correct a billing error on a claim that has been processed by Medicare Part B. 
Medical Policies

The Medicare Coverage Database contains all National Coverage Documents, Local Coverage Determinations (LCDs) and articles. The National Coverage Documents include National Coverage Determinations (NCDs), National Coverage Analyses (NCAs), Coding Analyses for Labs (CALs), Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) meetings, and Medicare coverage guidance documents.

Online Remittances
Palmetto GBA is pleased to offer secure and fast access to your Medicare online remittances through our eServices.
Reason Codes
Health Care Code lists to include CARCs, RARCs and Claim Status Codes are maintained by the Centers for Medicare and Medicaid Services (CMS). Providers are able to quickly locate additional claims and remittance advice details for these codes through the Washington Publishing Company (WPS) website.
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 B

 

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department


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