Become a Railroad Medicare Expert
You now have completed all the required steps to become a Railroad Medicare provider, but there’s still a lot to learn. Please review the links and information below to learn how to successfully file claims, review your remittance advice, and more.
Contact Railroad Medicare
Our Provider Contact Center (PCC) is here to help answer questions and resolve issues.
Email Updates
Receive customized daily or weekly emails on the latest Medicare news and Palmetto GBA features.
Medicare Dictionary
This index provides definitions for commonly used acronyms and Medicare terminology.
How Do I File Part B Claims to Railroad Medicare?
- Most providers submit electronic ANSI 837P claims. You are ready to submit claims electronically if you have completed Step 2 of this guide.
- Providers that meet exceptions to mandatory electronic billing may be allowed to submit CMS-1500 paper claim forms.
- eServices users also have the ability to submit paperless eClaims through the portal.
Submitting claims accurately is one of the most important things you will do as a Railroad Medicare provider. Our Claims section will walk you through the different ways you can file a claim, as well as help resolve any claim denials you experience.
What does Medicare Cover?
The CMS National Coverage Determinations and Medicare Benefit Policy Manual explain what items and services are covered by Medicare.
As a national Specialty Medicare Administrative Contractor, Railroad Medicare does not establish Local Coverage Decisions (LCDs) outside those LCDs which may be in use by the local A/B Medicare Administrative Contractors.
Understanding Your Remittance Advice
After your claim has been processed, you will receive a Remittance Advice containing information about your claim's payment, adjustments, denials, refunds, offsets, and more.
Filing an Appeal
Claims can be denied for a variety of reasons. Find out how you can file an appeal if you feel a claim was denied incorrectly.
Fee Schedules
A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers.