Enroll a Provider

Published 01/05/2024

How Do I Become a Railroad Medicare Provider?
The first step in becoming a Railroad Medicare provider is to request and receive a Railroad Medicare Provider Transaction Access Number (PTAN). You will need a separate PTAN for Railroad Medicare because we are a different jurisdiction from your local Part B Medicare Administrative Contractor (MAC).

Before requesting a Railroad Medicare PTAN, you must be actively enrolled with your local Part B MAC. Once you are enrolled as a Medicare Part B provider, you are eligible to render services for a Railroad Medicare beneficiary, but you must request and be assigned a Railroad Medicare PTAN before we can process your claims

Requesting a Railroad Medicare PTAN Is Easy!
You did the hard work when you enrolled with Part B Medicare. There are no CMS-855 enrollment forms required for Railroad Medicare. When you request a Railroad Medicare PTAN, Palmetto GBA verifies the enrollment information on file with your Part B MAC and creates a corresponding Railroad Medicare enrollment file.

The effective date of your Railroad Medicare PTAN will be retroactive to the effective date of your Part B Medicare PTAN.

If you have recently provided a Part B service to a Railroad Medicare beneficiary and are ready to submit your claim, follow these easy steps to request a Railroad Medicare Provider PTAN.

Because Railroad Medicare’s enrollment records will match what your local Part B MAC has on file, please make sure your enrollment information is current with your MAC before requesting a Railroad Medicare PTAN. If at any time your enrollment status with your local Part B MAC changes (such as failure to revalidate, provider revocations, provider suspensions, etc.), the same activity will occur with your Railroad Medicare PTAN.

Request a PTAN using the Railroad Medicare PTAN Lookup and Request Tool at www.palmettogba.com/RR/PTAN. The PTAN Tool will assign and release most new PTANs the day they are requested. Some requests may require research and you will be advised to allow 30 calendar days for processing and return to the tool to retrieve your PTAN information. To learn more, please see our article Using Railroad Medicare's Online PTAN Lookup and Request Tool.

If you recently enrolled with your local MAC, please wait 14 business days from the date you receive your local MAC PTAN before using this tool.

You can request a new Railroad Medicare PTAN for individual providers only (physician, nonphysician practitioner, ambulance, laboratory, ambulatory surgical center, etc.). Please do not attempt to request a new PTAN for a group/practice. A group PTAN will be created when an individual PTAN is assigned to the first group member.

If the provider information you enter on the tool does not match what your local Part B MAC has on its enrollment file, Railroad Medicare will not be able to complete your request. You will receive an online message explaining why.

Paper Claim Submitters. If you meet an exception to mandatory electronic filing, you have the option to submit your initial CMS-1500 paper claim(s) to obtain a Railroad Medicare PTAN. Once Railroad Medicare receives a CMS-1500 (02/12) form, we will obtain your enrollment data from your local MAC and issue you a Railroad Medicare PTAN if everything can be verified on the MAC’s file, including the Tax Identification Number (TIN) (item 25), and the billing name and billing address (item 33). If the claim documentation is incomplete or cannot be verified, you will receive a letter stating that your request cannot be completed.

After we authenticate your information with the local MAC’s provider enrollment file, we will send you a letter detailing your Railroad Medicare PTAN data. If you requested your PTAN via the Railroad Medicare PTAN Lookup and Request Tool, you can also access your new PTAN through the tool and download a PDF file with your PTAN details. The effective date of your Railroad Medicare PTAN will be the same as the effective date on your local Part B MAC enrollment record.
In order to enroll in Railroad Medicare’s Electronic Data Interchange (EDI), the provider must have a Railroad Medicare PTAN. To verify or request a new PTAN please use the online Railroad Medicare PTAN Lookup and Request Tool. Once you have your Railroad Medicare PTAN, then you can proceed with enrolling in EDI. EDI enrollment forms can be found using the following link: EDI Online Application.

Have questions? See our Frequently Asked Questions page.

Need more help? Please call our Provider Contact Center at 888–355–9165 for assistance. Choose Option 3 for Provider Enrollment.

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