Tips for Checking Medicare Claim Status

Published 06/29/2023

Health Insurance Portability and Accountability Act (HIPAA)-covered entities, like health plans, clearinghouses and certain health care providers, must comply with federal operating rules for checking claims status. These rules streamline how you get claim status information electronically. CMS has published an MLN Fact Sheet (PDF) that covers the following topics regarding claim status:

  • What Happens After I Submit a Claim?
  • How Do I Know My Accepted Claim’s Status?
  • When Should I Check My Accepted Claim’s Payment Status?
  • What’s a Clean Claim?
  • What’s the Waiting Period?
  • Which NPI Number Should I Use to Submit My Part B Claim?
  • How Do I Check My Claim Status?

For your convenience, Palmetto GBA offers multiple self-service tools for providers wishing to check the status/details of a claim. Please review the link below for additional details. 


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