Top Time-Saving Tools for Railroad Medicare Providers

Published 03/14/2023

Are you aware that Palmetto GBA Railroad Medicare 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 Railroad Medicare.

 

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

 

Function

Self-Service Tool Options

Appeals

Check the Status of Your Appeal

Use the Redetermination Status tool to find out if Railroad Medicare has received your Redetermination Request and whether your request is pending or completed. Enter the Internal Control Number (ICN) from your Medicare Remittance for the claim you appealed.

 

Submit Appeals Online in the eServices Portal

Use the Redetermination: First Level Appeal secure forms found on the Forms tab. You can upload supporting documentation as a PDF attachment to a secure form.

 

See section 8.0 of the eServices User Manual (PDF) for more details.

Claim Status

Check Claim Status on the Interactive Voice Response (IVR) System

Call the IVR at 877-288-7600. After provider validation, choose option 1 for Claim Status.

 

See the IVR User Guide (PDF) for more details.

Check Claim Status in the eServices Portal
Use the Claims tab to look up claim status with the patient’s Medicare ID and date of service or date range, or with a Claim Number.
 

See section 4.0 of the eServices User Manual (PDF) for more details.

Electronic Refunds and Immediate Offset Requests

eChecks and eOffsets in the eServices Portal

On the Financial Tools tab, use the Financial Forms subtab to submit immediate offset requests for Medicare overpayments, or eCheck electronic payments for Railroad Medicare overpayments and voluntary refunds online.

 

See section 7.0 of the eServices User Manual (PDF) for more details.
Eligibility Check Patient Eligibility on the Interactive Voice Response (IVR) System
Call the IVR at 877-288-7600. After provider validation, choose option 3 for Eligibility.

See the IVR User Guide (PDF) for more details.

Check Patient Eligibility in the eServices Portal
Use the Eligibility tab to look up patient eligibility details with the patient’s Medicare ID, name, and date of birth. Enter a date range to receive all available eligibility information.  

See section 6.0 of the eServices User Manual (PDF) for more details.

Payment and Overpayment Data

Request Your Payment Floor Status and Last Three Checks Paid on the IVR

Call the IVR at 877-288-7600. After provider validation, choose option 2 for Financials.

 

See the IVR User Guide (PDF) for more details.

 

Look up Your Payment Floor Status and Last Three Checks Paid in the eServices Portal

On the Financial Tools tab, use the Cash Flow Snapshot subtab to look up your payment floor status and last three checks paid.

 

See section 7.0 of the eServices User Manual (PDF) for more details.

 

Look up Overpayment Data in the eServices Portal

On the Financial Tools tab, use the new Overpayment Data subtab to find the real-time status of an Accounts Receivable (AR) or Demand Letter balance. Enter the AR Transaction number or the Demand Letter number to see the following balance information:

  • AR demand letter issue date
  • Number of overpayments associated with the demand letter
  • Principal Original Amount and Principal Remaining Balance
  • Interest Accrued to Date and Interest Remaining Balance
  • AR Total Remaining Balance

See section 7.0 of the eServices User Manual (PDF) for more details.

Provider Enrollment

Railroad Medicare PTAN Lookup and Request Tool

Use the Railroad Medicare PTAN Lookup and Request Tool to:

  • Verify if a provider has a Railroad Medicare Provider Transaction Access Number (PTAN) / Lookup an existing Railroad Medicare PTAN
  • Request a new Railroad Medicare PTAN

Before using the PTAN Tool, please review the following resource: Using Railroad Medicare's Online PTAN Lookup and Request Tool.

Remittance Advice

Order a duplicate Standard Paper Remittance (SPR) on the IVR

Call the IVR at 877-288-7600. After provider validation, choose option 4 for Duplicate Remit.

 

See the IVR User Guide (PDF) for more details.

 

View/print/download Remittances Online in the eServices Portal

Look up remittances by check number or date on the Remittance tab. Remittances are also accessible directly from the Claim Summary screen after performing a claim status inquiry.

 

See section 5.0 of the eServices User Manual (PDF) for more details.
Reopenings/Simple Claim Corrections

Request Reopenings Online in the eServices Portal: Two Options

1) Submit your request on the Reopening: Simple Claim Correction secure forms found on the Forms tab. If needed, you can upload supporting documentation as a PDF attachment to a secure form.

See section 8.0 of the eServices User Manual (PDF) for more details.

2) Perform a Reopening Request from the Claim Status Information screen to request simple corrections to the following claim line fields: HCPCS code, modifier fields, date(s) of service, place of service code, number of units and submitted charges.

See section 4.0 of the eServices User Manual (PDF) for more details.

Webchat

Chat Securely with Us on the Railroad Medicare Website and the eServices Portal

 

Use our secure chat feature to interact with designated Railroad Medicare staff to receive real-time assistance in locating information on the Railroad Medicare website and for assistance with patient- or provider-specific questions that require the sharing of PHI information.

 

When Chat is available, you will see a green Chat Now button in the lower right side of your screen.

 

Chat is also available on the eServices portal. Once in the portal, choose from the chat options for Medicare Inquiries or eServices Help.

 


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