WHAT'S NEW
New Membership Flier
Sex, Shopping, Gambling and Gaming: Addictions in the 21st Century
January 29, 2011
Download the flier
2010 Continuing Education Workshops
Watch this space for future workshops.
New BBS Fingerprint Requirement for Licensees and Registrants
New Information for California Medicare Providers
Palmetto GBA
As you may know, Centers for Medicare & Medicaid Services (CMS) has awarded the contract for the combined administration of Part A and Part B Medicare fee-for-service claims in Jurisdiction 1 (J1) to Palmetto GBA. California falls into Jurisdiction 1 (J1). As with most transitions, fee-for-service (FFS) providers may face a period of start-up problems. However, we have recently heard from several members that they received payment from Palmetto for long overdue unpaid claims that had been sent to NHIC.
We have been given the following address for mailing paper claims along with a phone number for customer service. [By way of explanation: The first line designates Jurisdiction 1 (California is part of Jurisdiction 1) and MAC refers to Medicare Administrative Contractor]
J1 MAC
Palmetto GBA
PO Box 1051
Augusta, GA 30903-1051
Customer Service: (866) 931-3901
The following "tips" are from Palmetto to help providers:
Claims Corrections and Appeals: Tips for Faster Service
Palmetto GBA processes "reopenings" (claim corrections) and redetermination requests (first level appeals) for all Jurisdiction 1 providers, including requests related to claims that were processed by the previous contractors. We are committed to providing you with the best possible service for these requests. To ensure that we are able to handle your requests for reopenings and redeterminations correctly and efficiently, please include a copy of your original remittance notice and any other written communication from the previous contractor, such as an automated development request (letter), with all written requests for reopenings and redeterminations.
Applies to: Jurisdiction 1//J1 Part B: General