Submit Home Health RCD Pre-Claim Review Requests with your Correct PTAN
Palmetto GBA is seeing an increase of pre-claim review (PCR) submissions with incorrect Provider Transaction Access Numbers (PTANs), also known as CMS Certification Numbers (CCNs).
Please remember that:
- PCR requests are rejected when Palmetto GBA is unable to process the request due to incomplete or invalid information. This will cause delays in receiving a Unique Tracking Number (UTN).
- Any final bill submitted with a PTAN that differs from the PTAN on the corresponding UTN will cause an Additional Documentation Request (ADR) to be generated which will require a response and be subject to the 25 percent payment reduction on the final allowed amount.
If a PCR request is submitted under an incorrect PTAN, the provider should submit a new initial PCR submission (not a resubmission) with the correct PTAN. Both PCR requests will be included in the affirmation rate.
eServices submitters must ensure they are billing under the correct PTAN. Users who have linked multiple PTANs under one default ID through the Account Linking process must ensure they select the correct PTAN for PCR requests. Users can easily switch between their linked accounts/PTANs by using the Provider dropdown box located near the top of each tab. Simply click on the dropdown box to display the list of all linked accounts available and select the desired provider account. See the eServices User Manual (PDF) for more information about account linking.