Orlando Harmon
Palmetto GBA is a leading provider of technical and administrative services for the federal government, specifically for Medicare. It is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC) and processes Part B claims for Railroad Retirement beneficiaries nationwide. Palmetto GBA is contracted by the Railroad Retirement Board (RRB), an independent federal agency that administers retirement, survivor, and unemployment-sickness benefit programs for railroad workers and their families. Palmetto GBA also won a major Medicare contract for Jurisdiction J, which includes the states of Alabama, Georgia, and Tennessee, and covers more than 2.5 million Medicare beneficiaries. With this context in mind, it is important to understand how Palmetto GBA handles situations where an individual has primary Medicare coverage and secondary insurance from another provider.
| Characteristics | Values |
|---|---|
| Medicare Administrative Contractor for | Jurisdiction J (Alabama, Georgia, and Tennessee) |
| Railroad Retirement Board (RRB) | |
| Medicare Parts Covered | A and B |
| Number of Administrative and Professional Employees | 460+ |
| States with Offices | Alabama and South Carolina |
| Railroad Medicare Number | (800) 833-4455 |
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What You'll Learn
- Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor
- It processes Part B claims for Railroad Retirement beneficiaries
- Palmetto GBA is contracted by the Railroad Retirement Board
- The Railroad Retirement Board administers retirement and sickness benefits for railroad workers
- Palmetto GBA provides Medicare Part A and Part B services
Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor
Palmetto GBA is based in Columbia, South Carolina, and is a leading provider of technical and administrative services for the federal government. They continuously work to improve the administration of the Medicare program by offering innovative solutions to complex problems and providing excellent service.
As the Medicare Administrative Contractor for Jurisdiction J, which includes the states of Alabama, Georgia, and Tennessee, Palmetto GBA serves more than 2.5 million Medicare beneficiaries, over 52,000 physicians, and 400 hospitals that serve Medicare patients. Jurisdiction J represents 7% of the national Part A/Part B claim-volume workload.
The contract with Palmetto GBA began in 2018 and employs more than 460 administrative and professional employees within its offices in Alabama and South Carolina. They are responsible for conducting extensive outreach to healthcare providers, state medical associations, and beneficiaries to provide education and information about the transition.
Palmetto GBA offers a toll-free Interactive Voice Response (IVR) system to check the status of Railroad Medicare Part B claims. This system is available Monday through Friday from 7 a.m. to 11 p.m. ET, and Customer Service Representative Representatives (CSRs) are available to assist callers as needed.
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It processes Part B claims for Railroad Retirement beneficiaries
Railroad retirement beneficiaries in the United States are covered by Medicare, just like workers under social security. Medicare Part B covers fees from physicians, laboratories, and other practitioners.
Palmetto GBA, a subsidiary of Blue Cross and Blue Shield, is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC). It processes Part B claims for Railroad Retirement beneficiaries nationwide. If you are in the Original Medicare Plan, your hospital, doctor, or other healthcare provider should submit Part B claims directly to Palmetto GBA. You can also call Palmetto GBA's toll-free number or visit their website for help with Part B claims. Additionally, you can check the status of your Railroad Medicare Part B claim by calling the Palmetto Interactive Voice Response (IVR) system toll-free.
Palmetto GBA is contracted by the Railroad Retirement Board (RRB). The RRB's toll-free telephone service provides customers with easy access to agency representatives and automated menus available 24 hours a day. Railroad retirement beneficiaries can also find additional materials on the Medicare benefits page at RRB.gov or the Medicare and Palmetto GBA information sources.
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Palmetto GBA is contracted by the Railroad Retirement Board
Palmetto GBA is based in Columbia, South Carolina, and is a leading provider of technical and administrative services for the federal government. The company continuously works to improve the administration of the Medicare program by offering innovative solutions to complex problems and providing excellent service.
In addition to its contract with the Railroad Retirement Board, Palmetto GBA was also selected by the federal Centers for Medicare & Medicaid Services (CMS) as the Medicare Administrative Contractor for Jurisdiction J, which includes the states of Alabama, Georgia, and Tennessee. Jurisdiction J represents 7% of the national Part A/Part B claim-volume workload and includes more than 2.5 million Medicare beneficiaries, more than 52,000 physicians, and 400 hospitals that serve Medicare patients.
The contract with CMS is for a period of five years and will employ more than 460 administrative and professional employees within Palmetto GBA offices in Alabama and South Carolina. Palmetto GBA assumed full responsibility for Part A claims by the end of January 2018 and Part B claims by the end of February 2018.
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The Railroad Retirement Board administers retirement and sickness benefits for railroad workers
The Railroad Retirement Board (RRB) is an independent federal agency that was created in 1935 to administer a social insurance program for the country's railroad workers. The RRB is headquartered in Chicago, Illinois, and has field offices across the country. It serves US railroad workers and their families by administering retirement, survivor, unemployment, and sickness benefits. These benefits are funded by taxes paid by railroad employees and employers, with Tier I taxes being the same as Social Security taxes, and Tier II taxes contributing to financing benefit payments in excess of Social Security coverage.
The RRB's primary function is to determine and pay out benefits under the retirement-survivor and unemployment-sickness programs. To this end, the RRB employs field representatives to help railroad personnel and their families file claims for benefits, examiners to adjudicate these claims, and IT staff to maintain earnings records, calculate benefits, and process payments. The RRB also employs actuaries, statisticians, economists, and attorneys to support its operations.
The Railroad Retirement program was established in the 1930s to address concerns about the ability of existing pension programs to provide adequate assistance to former railroad workers in old age. It is similar to the Social Security program but remains separate and has key differences in funding and benefit structure. The program provides benefits to individuals who have spent a substantial portion of their career in railroad employment and their families.
The RRB has administrative responsibilities under the Social Security Act for certain benefit payments and railroad workers' Medicare coverage. It also has responsibilities under the Railroad Retirement and Railroad Unemployment Insurance Acts. In 1938, the program introduced unemployment benefits, and in 1946, it expanded to include survivor, sickness, and occupational disability benefits. Spousal benefits were added in 1951.
To receive Railroad Retirement benefits, individuals must apply by contacting their nearest RRB office. Retirement annuity payments generally begin at age 60 with 30 years of qualifying railroad service or at age 62. The RRB also provides a "Spousal Annuity," which is payable once the spouse reaches a certain age, depending on the employee's age, retirement date, and years of railroad service.
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Palmetto GBA provides Medicare Part A and Part B services
Palmetto GBA is a leading provider of technical and administrative services for the federal government. They have been selected as the Medicare Administrative Contractor (MAC) for Jurisdiction J, which includes the states of Alabama, Georgia, and Tennessee. Jurisdiction J covers more than 2.5 million Medicare beneficiaries, 52,000 physicians, and 400 hospitals serving Medicare patients.
As a MAC, Palmetto GBA processes Medicare Part A and Part B services for Railroad Retirement beneficiaries nationwide. Part A helps cover fees from hospitals, skilled nursing facilities, and other institutional providers, while Part B covers fees from physicians, laboratories, and other practitioners.
For Railroad Medicare Part B claims, Palmetto GBA offers an interactive voice response (IVR) system that beneficiaries can call toll-free to check their claim status. They also provide online provider portals that give authorized healthcare providers access to claims history, eligibility information, and tools to look up Medicare Numbers.
Palmetto GBA continuously works to improve the administration of the Medicare program by offering innovative solutions and excellent service. They conduct extensive outreach to healthcare providers, state medical associations, and beneficiaries to provide education and information about transitions.
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