February 11, 2016

Medicare Part B premium costs for 2016

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The Centers for Medicare & Medicaid Services (CMS) has released the 2016 Part B premium and deductible costs for 2016. Railroad Medicare processes claims for Part B services.  The 2016 monthly premiums will remain unchanged for approximately 70 percent of Medicare beneficiaries. However, the remaining 30 percent will pay a different amount based on the [...]

Palmetto GBA: when a doctor’s notes are not readable

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We all know the joke: if you have poor penmanship, you should become a doctor.  Unfortunately, poor penmanship on patient notes and records can lead to claim denials, because if Medicare can’t read what the doctor wrote, we can’t know if the services were reasonable and necessary and meet all guidelines for coverage. Medicare requires [...]

Medicare’s program integrity initiatives

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For many years, the Centers for Medicare & Medicaid (CMS) has funded programs to reduce claims payment errors (either paying too much, paying too little or payments being made when none should be).  Some of these programs are handled through systematic checks that look for anomalies and mismatched services, and some are handled through clinical [...]

A new year can mean a new you with Medicare

The start of a new year is the time for resolutions. Railroad retirees covered under Medicare can receive the help they need in making some of their resolutions a reality. According to USA.gov, the top three New Year’s resolutions are: Lose Weight Volunteer Quit Smoking The year 2015 can be a year of change with [...]

Palmetto GBA conducting Railroad Medicare survey

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Palmetto GBA is conducting a Railroad Medicare Beneficiary Satisfaction Survey. The survey is designed to collect data on beneficiary satisfaction regarding its performance as Railroad Medicare’s contractor. The survey will be sent to a random sample of approximately 8,000 Railroad Medicare Beneficiaries. The surveys will be included in an upcoming Medicare Summary Notice (MSN). Palmetto GBA is listening and wants [...]

Mental health care and Railroad Medicare coverage

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Mental health conditions, such as depression or anxiety, can come at any age and can happen to anyone. They are nothing to be ashamed of. While they can occur at any time, stressful holidays and the let-down after the holidays often make these conditions worse. With that in mind, it’s important to know that Railroad [...]

Medicare: Consider insurance when traveling abroad

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When planning a foreign trip, it’s highly unlikely your first thought would be, “Will Medicare pay if I get injured or have a medical emergency before I get back home?” Many patients think their Medicare benefits will provide coverage, wherever they go. Unfortunately, this isn’t true and can lead to costly, and avoidable, mistakes. Generally, [...]

Need a doctor? Here’s how to find one

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If you find yourself in need of a doctor, and you don’t know if one practices near you, or if they participate in Medicare, and you have internet access, you can use the ‘Physician Compare’ tool at www.Medicare.gov. Physician Compare is a website maintained by the Centers for Medicare and Medicaid Services (CMS), and it [...]

When Railroad Medicare pays first or second

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When Medicare began in the 1960s, it was the primary payer for all services except those covered by workers compensation. In 1980, Congress enacted provisions to shift costs from the Medicare program to private insurers, when possible. This legislation stopped Medicare from making payment if the payment had already been made, or would be expected [...]

Railroad Medicare is Part B Medicare for retirees

Palmetto GBA is reminding railroad retirees that Railroad Medicare Part B provides coverage for services such as doctors’ visits, ambulance transports, lab tests and some supplies. Benefits are the same for eligible individuals, whether eligibility is through Railroad Retirement or Social Security. Railroad Medicare is funded by a portion of Railroad Retirement Tier I and [...]