The transition from NHIC to Palmetto is causing serious problems for California physicians.  CMA is receiving a very high number of complaints from members who have not received payment for Medicare claims submitted both before and after the transition. Several members have been forced to access credit lines to meet payroll and business expenses, and we are now hearing from physicians who are fearful that the situation may cost them their practice. While CMA has been very successful in getting resolution for physicians who contact our Center for Economic Services, doctors who are going directly to Palmetto for assistance are finding it impossible to get through on their phone lines. Practices that do get through are facing wait times of as much as three hours.

CMA has compiled a list of common problems and fixes and posted it online at http://www.cmanet.org/palmetto. Physicians who are still experiencing payment problems are encouraged to review this list to see if their issues are addressed. If after doing so you still have questions or problems, please contact CMA’s Reimbursement Help Line for assistance.

CMA continues to work with Palmetto and Center for Medicare & Medicaid Services (CMS) on a global fix of the situation. We have also secured commitments from many Congressional offices to intervene in the situation.

As reported in the last Alert, CMS authorized Palmetto to add 35 additional staffed phone lines. These phone lines should be active today. Palmetto has also indicated it will add an additional 15 phone lines later this week that will be dedicated to provider enrollment issues.

Contact: CMA’s Reimbursement Help Line, 888/401-5911.