Getting Rail road Medicare PTAN

Railroad Medicare Provider Enrollment


Before establishing a Railroad Medicare Provider Transaction Access Number (PTAN) the provider must first be enrolled with their local carrier.

ESTABLISHING A RAILROAD MEDICARE PTAN

FOR ELECTRONIC SUBMITTERS Effective July 1, 2005, Change Request 3440 was implemented. This Change Request mandates that all providers submit claims electronically. Only providers that have been granted a waiver or meet exception qualifications are excluded.

Once the provider(s) has a pending claim(s), they may complete the Request for Railroad Medicare PTAN form or they may call 1-866-899-5227 to make a telephone request for a Railroad Medicare PTAN. Please be prepared to provide the provider’s Legal Business Name, NPI, organizational/group NPI, complete name, tax identification number (TIN), and billing and practice address information.

NOTE: If the information obtained on your enrollment request does not match your local Medicare Part B Carrier’s files, a letter will be sent informing you that the request cannot be completed.

FOR PAPER SUBMITTERS Providers that are waived from filing electronically may submit their initial paper claims to obtain a PTAN. · Once a CMS-1500 (08-05) claim form has been submitted to Railroad Medicare, we will obtain your enrollment information from your local carrier and issue the provider a Railroad Medicare PTAN if all information is verified on the Part B Carrier's file. · Make sure that prior to submitting claims to Railroad Medicare that the information submitted on the CMS-1500 (08-05) claim form is consistent with the information on file with the local carrier. This includes the TIN (Item 25), billing name and billing address (Item 33). If the claim information is incomplete or cannot be verified a letter will be sent informing you that the request cannot be completed. BILLING ADDRESS CHANGES TO AN EXISTING RAILROAD MEDICARE PTAN · You may submit a written request to update your Railroad Medicare PTAN to: Railroad Medicare P. O. Box 10066 Augusta, GA 30999-0001

· Provider/Suppliers must first be enrolled with their local carrier; therefore, your local carrier must first complete any changes that need to be made to an existing provider file. · Providers/Suppliers that submit claims electronically should call Provider Enrollment to report any changes. We will verify the new information with the local carrier and make the necessary updates. · Information submitted on the CMS-1500 (08-05) form that is inconsistent with the local carrier files will result in the claim being returned to the provider with a letter explaining any inconsistency.