Railroad Retirement Beneficiary Carrier (Rev. 142, 04-16-04)

by  Find-A-Code
July 9th, 2015

Carrier jurisdiction claims for individuals who are QRRBs, including those who are entitled to both social security and railroad retirement benefits, are handled by the Palmetto Government Benefits Administrators (GBA) LLC, a subsidiary of Blue Cross and Blue Shield of South Carolina, with the following exceptions:

• The services are furnished by a M+C organization which deals directly with CMS on a cost basis;

• The QRRB is enrolled under a buy-in agreement involving a State agency that has entered into an agreement to act as a carrier with respect to such individuals; or;

• The medical services were provided outside the United States, in which case the RRB handles the claim. (See §10.1.4.6 for handling claims for services in Mexico.)

If a claim involves medical services provided both within and outside the United States, Palmetto GBA processes the claim for the medical services provided within the United States. If the claimant raises a question as to why the medical services provided outside the United States were not paid, Palmetto GBA directs the claimant to contact the RRB and forwards the claims to them at:

Railroad Retirement Board Division of Disability and Health Insurance

844 Rush St.

Chicago, IL 60611

 

Pub 100-04 Medicare Claims Processing Manual

References:

Railroad Retirement Beneficiary Carrier (Rev. 142, 04-16-04). (2015, July 9). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/railroad-retirement-beneficiary-carrier-rev-142-04-16-04-27165.html

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