Customer Service

Published 06/20/2024

For provider inquiries, you can call the Provider Contact Center toll-free at 888–355–9165, Monday through Friday, from 8:30 a.m. to 4:30 p.m. for all time zones with the exception of Pacific Time (PT) which receives service from 8 a.m. to 4 p.m. PT.

When you call the toll-free 888–355–9165 line, the system provides the following options:

Press 1 for Claim Status, Eligibility or a Duplicate Remittance Advice

Please note: Claim status, beneficiary eligibility and duplicate remittance advice should be requested through our Interactive Voice Response (IVR) unit at 877–288–7600 or through our secure internet portal, eServices.

Press 2 for Technical Support Regarding EDI or eServices, then

  • For eServices Inquiries, press 1
  • For EFT, press 2
  • For technical assistance with electronic billing, Electronic Remittance Advice (ERA) or other EDI issues, press 0

Press 3 for Provider Enrollment

Press 4 for Telephone Reopening, then

  • For the explanation of a denied claim, press 1
  • To request a telephone reopening to correct minor errors or omissions, press 0

Press 5 for Customer Service

  • To speak to a Customer Service Advocate, press 0

Press 6 for Our Mailing Address and Hours of Operation

Press 9 to repeat this menu 

Last Reviewed: 6/20/2024

You can email a question to Railroad Medicare using the email link on our Contact Us page. Just look for the Contact Us link in the toolbar at the top of each Railroad Medicare website page. 

In order to ensure your privacy, please do not transmit Protected Health Information including any of the following information to Palmetto GBA via email. Revealing this information online could expose you or others as a target for Medicare fraud and abuse.

  • Personal information, including Social Security numbers, which you would like to keep private
  • Beneficiary information, including Health Insurance Claim (HIC) numbers or Medicare Beneficiary Identifiers (MBIs), coinsurance and deductible information, dates of Medicare entitlement, copies of or information from Medicare claim forms, Medicare reports of eligibility, and Medicare Summary Notices (MSNs)
  • Information covered under the Freedom of Information Act (1967) and/or the Privacy Act of 1974
  • Claim-specific data

Email responses to your questions will be processed according to CMS standard timeliness guidelines for all written inquiries. For an immediate response to your questions, providers should contact the Railroad Medicare Provider Contact Center (PCC) at (888) 355–9165.

Last Reviewed: 6/20/2024

You can request a duplicate remittance from Railroad Medicare using the following self-service tools. 

Palmetto GBA's eServices
Providers that have an Electronic Data Interchange Enrollment Agreement on file with Palmetto GBA Railroad Medicare can access their remittance notices through our eServices internet portal. In addition to using eServices to view and print a duplicate remittance notice, you can store remittances and utilize search features to find specific information on the notices.

Interactive Voice Response (IVR)
Providers can use the IVR to order a duplicate remittance notice for a specific claim, or for a specific check or EFT number. To request a duplicate remittance notice through the IVR, call 877–288–7600 and select option 1 from the main menu, then option 4 from the next menu. If you need assistance with entering letters in the correct format use our IVR Conversion Tool

Last Reviewed: 6/20/2024

Beside the article title you will see a horizontal line of symbols:

  • Click the "aA" symbol to increase the size of the text 
  • Click the "Aa" sumbol to decrease the size of the text 

Last Reviewed: 6/20/2024

No. The Interactive Voice Response (IVR) system, eServices, and customer service representatives access the same data to check claims information. If the IVR and/or eServices cannot locate the claim, please verify the information submitted on the claim is correct. 

If the claim was sent electronically using a clearinghouse or billing service, contact them for a receipt confirmation from Railroad Medicare. Also verify that your provider has an Electronic Data Interchange (EDI) agreement on file with Palmetto GBA Railroad Medicare. Electronic claims for providers who are enrolled to submit electronic claims to Railroad Medicare should be submitted using EMC payer number 00882.

Paper claims must be submitted on a CMS-1500 (02/12) red-and-white claim form and mailed to:

Palmetto GBA Railroad Medicare
PO Box 10066
Augusta, GA 30999

Last Reviewed: 6/20/2024

You will be asked to provide the following information about the beneficiary:

  • The beneficiary's last name
  • The beneficiary’s first name or initial
  • The beneficiary's Medicare Beneficiary Identifier (MBI) and either
    • The claim date(s) of service (for post-claim inquiries, such as reason for denial or rejection); or 
    • The beneficiary's date or birth (for pre-claim inquiries, such as entitlement requests/issues)

The Centers for Medicare & Medicaid Services (CMS) requires authentication of these beneficiary elements prior to disclosing personally-identifiable information (PII) or protected health information (PHI) about a Medicare beneficiary to an authenticated provider. All information must match. If you are not able to provide the required elements, our Customer Service Advocates may ask you to obtain the information and call back. 

Last Reviewed: 6/20/2024

You will be asked to provide the following information:

  • The provider's National Provider Identifier (NPI)
  • The provider's Railroad Medicare Provider Transaction Access Number (PTAN)
  • The provider's Tax Identification Number (TIN): last five digits or the complete TIN for Provider Enrollment details

The Centers for Medicare & Medicaid Services (CMS) requires authentication of these provider elements whenever a request would involve the disclosure of personally-identifiable information (PII) or protected health information (PHI). If you are not able to provide the required elements, our customer service advocates may ask you to obtain the information and call back.

Last Reviewed: 6/20/2024

The Railroad Medicare Provider Call Center has the capability for hearing impaired providers and their staff to communicate by using Teletypewriter/Telecommunications Device for the Deaf (TTY/TDD) services. The TTY/TDD phone number for the Railroad Medicare Provider Service Center is 877–715–6397.

A TTY/TDD is a special device which permits hearing-impaired individuals to use a telephone that has typing and receiving capabilities. It is required for sending and receiving messages during a telephone conversation.

Last Reviewed: 6/20/2024

The Centers for Medicare & Medicaid Services (CMS) requires contractors to offer self-service and electronic communication technologies as efficient, cost-effective means of disseminating Medicare provider information, education and assistance. Our Interactive Voice Response (IVR) System is an important self-service tool available to providers for obtaining a wide variety of information, including claim status, beneficiary eligibility and deductible information. 

Railroad Medicare offers providers the option to check claim status, beneficiary entitlement and deductible information on our eServices internet portal. To register for eServices, providers must first have an Electronic Data Interchange Agreement on file with Palmetto GBA Railroad Medicare. Learn more about eServices.

Providers are required to use the IVR or eServices to access claim status, beneficiary eligibility and deductible information. CSRs will refer providers to the IVR or eServices for questions that can be handled by those self-service tools. 

Resource: For additional information on CMS guidelines for Provider Contact Centers, refer to the CMS Beneficiary and Provider Communications Manual, Pub. 100-09, Chapter 6 (PDF).

Last Reviewed: 6/20/2024

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