Medicare

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New Medicare Card – Transition begins April 1, 2018

Monday, December 18th, 2017

On April 1, 2018, CMS will start mailing Medicare cards with new Medicare Beneficiary Identifiers (MBIs) to everyone with Medicare. The MBI will replace the Social Security Number (SSN)-based Health Insurance Claim Number for transactions like billing, eligibility status, and claim status after a transition period. You must be ready to accept the MBI beginning […]

Medicare Part B Secondary Payer Deductible Issues

Friday, August 19th, 2011

Medicare Part B claims processed after Friday, April 1, 2011, for which the beneficiary has a Medicare deductible remaining and Medicare is the secondary payer, are erroneously issuing payment despite the beneficiary’s deductible not being satisfied or despite the total Medicare Allowed Amount being applied towards the deductible. The recovery of overpayments made during this […]

Medicare physician payment may be reduced by a third

Thursday, December 9th, 2010

Providers can expect a reduction in Medicare payment of more than 30 percent in 2011 unless Congress grants a reprieve. In the Medicare physician fee schedule (MPFS) final rule that the Centers for Medicare and Medicaid Services has placed on display, providers paid under the MPFS are looking at a 2011 conversion factor of $25.5217, […]

Medicare Egilibility via Palmetto GBA

Tuesday, November 30th, 2010

It used to be that if you need to check patient Medicare eligibility or claim status, you have only two options: Call the Interactive Voice Response (IVR) system at (866) 931-3903 Use the ANSI 270/271 Beneficiary Eligibility Inquiry transaction at the CMS data center Anybody who has used the IVR system knows it’s an annoying […]

Anybody Home in Palmetto GBA’s Provider Enrollment Dept?

Monday, October 25th, 2010

I’ve been trying to get through to Palmetto GBA’s Provider Enrollment Dept for the past 2 days.  Here’s a tip to get through.  Use two phone lines and alternately redial when the call goes directly to answering machine.  The message that says “..you have reached this recording because we are experiencing higher than expected call […]

Can’t get through to Palmetto GBA Provider Enrollment

Wednesday, December 16th, 2009

Things are going from bad to worse.  Provider enrollment incorrectly linked one of our provider’s corporate tax id to his personal NPI and deny the entire batch of claims for lacking information.  I’m trying to enlighten them on this matter but have been able to get through to Provider Enrollment as ‘all circuits are busy’ […]

Palmetto Provider Enrollment Wait Time

Tuesday, October 27th, 2009

I called Palmetto Provider Enrollment and was on hold for almost 2 hours today! Wondering when are they going their act together?

Setting up Medicare Electronic Billing with Palmetto GBA

Thursday, October 22nd, 2009

It used to only take a couple of weeks to set up electronic billing with NHIC now it takes approximately 40 days and that is if you submit your request online.  Also, you can only submit online (Electronic Data Interchange Application Online Request Form) if the provider is already billing electronically.  Here’s the link: http://www3.palmettogba.com/pgx_ediRequest/index.jsp […]

CMS Offers Web-based Enrollment in 15 States and District of Columbia

Sunday, December 7th, 2008

Physicians in 15 states (Delaware, Minnesota, New Jersey, Idaho, Missouri, North Carolina, Illinois, Nebraska, Pennsylvania, Iowa, Maryland, Tennessee, Kansas, Michigan, Wisconsin and the District of Columbia) can now use CMS web-based system, PECOS ( Provider Enrollment, Chain and Ownership System)  site to Apply for Medicare enrollment online display and update current enrollment data check application […]

LACMA: Palmetto Seminar

Friday, November 21st, 2008

Lacma and Palmetto are hosting two educational seminars on the J1-Post Transition on December 9, 2008 to address the issues provider are facing with the switch from NHIC to Palmetto. Free to Lacma members and cost is $100/person for non-members. Please see www.lacmanet.org for full details.

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