Palmetto/J1MAC Website Update

The following updates have been posted to the Palmetto/J1MAC website.

Does Palmetto GBA only accept paper claims printed from a laser printer?
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Does%20Palmetto%20GBA%20only%20accept%20paper%20claims%20printed%20from%20a%20laser%20printer%3F?opendocument

Does Palmetto GBA only accept paper claims printed from a laser printer?

Applies to:
Part A Transition: General
Part B Transition: General
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Our provider has two offices, one that bills paper claims and one that must
bill electronically, due to missing filing paperwork. After the
transition, will our office be able to file the appropriate paperwork to
file paper claims?
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Our%20provider%20has%20two%20offices%2C%20one%20that%20bills%20paper%20claims%20and%20one%20that%20must%20bill%20electronically%2C%20due%20to%20missing%20filing%20paperwork.%20%20After%20the%20transition%2C%20will%20our%20office%20be%20able%20to%20file%20the%20appropriate%20paperwork%20to%20file%20paper%20claims%3F?opendocument

Our provider has two offices, one that bills paper claims and one that must
bill electronically, due to missing filing paperwork. After the
transition, will our office be able to file the appropriate paperwork to
file paper claims?

Applies to:
Part A Transition: EDI
Part B Transition: EDI
Part A Transition: General
Part B Transition: General
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Part B
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B?opendocument

Palmetto GBA has posted articles outlining Part B claims processing
changes and/or reminders. The information contained in these articles is
applicable after the transition to the MAC contractor. Billing and
submission processes used by the current contractor remains in effect until
after the transition.

New articles added 7/24/2008:
* Ambulatory Surgical Centers
* Avastin Coverage for Age-Related Macular Degeneration
* CPT Modifier 24
* CPT Modifier 79
* Drug Injections and Infusions - Use of Quantity Billed Field
* Electronic Claims and FAX Attachments
* Electronic Claims - Valid MSP Types
* Hemophilia Clotting Factors
* Hospice Services
* How to Submit an NOC Drug Code
* Interpretation of a Peripheral Blood Smear
* Modifiers that Require Additional Documentation
* MSP Claims Submitted with Patient Paid Amount
* Multiple NOC Drug Codes
* Repeat or Duplicate Service on Same Day
* Submitting Claims for Compounded Medications

Applies to:
Part B Transition: General
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Part B Interactive Voice Response (IVR) Job Aids
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20Interactive%20Voice%20Response%20(IVR)%20Job%20Aids?opendocument

For assistance in obtaining Medicare Part B (including Claim, Financial,
General and Eligibility) information using the Palmetto GBA Interactive
Voice Response (IVR) system, please refer to these Job Aids.

Applies to:
Part B Transition: General
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Telephone Reopenings
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Telephone%20Reopenings?opendocument

Providers and Beneficiaries may request to have their Medicare claim
reopened over the telephone. A claim can be reopened to correct minor
errors or omissions by calling our toll free line at 1-866-669-5543 Monday
through Friday from 7:00a.m. to 3:00p.m. Pacific Time. A maximum of three
(3) requests can be handled during the same phone call.

Applies to:
Part B Transition: General
----------


When a beneficiary is retroactively granted Medicare eligibility, does
Palmetto GBA have the capability to view when decision was made so that
claims filed beyond the time limit do not deny?
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/When%20a%20beneficiary%20is%20retroactively%20granted%20Medicare%20eligibility%2C%20does%20Palmetto%20GBA%20have%20the%20capability%20to%20view%20when%20decision%20was%20made%20so%20that%20claims%20filed%20beyond%20the%20time%20limit%20do%20not%20deny%3F?opendocument

When a beneficiary is retroactively granted Medicare eligibility, does
Palmetto GBA have the capability to view when decision was made so that
claims filed beyond the time limit do not deny?

Applies to:
Part A Transition: General
Part B Transition: General
----------


When a resident is in a covered Part A stay, receives services from an
outside provider, and the provider sends a 1500 bill to the SNF for
payment, we use the CMS Carrier File 1 to determine the SNF's
responsibility. Is this correct?
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/When%20a%20resident%20is%20in%20a%20covered%20Part%20A%20stay%2C%20receives%20services%20from%20an%20outside%20provider%2C%20and%20the%20provider%20sends%20a%201500%20bill%20to%20the%20SNF%20for%20payment%2C%20we%20use%20the%20CMS%20Carrier%20File%201%20to%20determine%20the%20SNFs%20responsibility.%20%20Is%20this%20correct%3F?opendocument

When a resident is in a covered Part A stay, receives services from an
outside provider, and the provider sends a 1500 bill to the SNF for
payment, we use the CMS Carrier File 1 to determine the SNF's
responsibility. Is this correct?

Applies to:
Part A Transition: General
Part B Transition: General