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More Palmetto GBA’s Bureaucracy

It is now 6 weeks into the transition and Palmetto’s Medicare CMS contract transition is still causing financial strain for thousands of clinics and providers.  So we thought it would be fun to track and share some of our own issues.

Yes, Palmeto – you’re so special that we’ve created a whole section on our site just for you.

Providers – Feel free to comment and share your experiences here as well.  Just remember no cursing allowed (unless justified ;-).


  • Nancy Hoffman

    December 2, 2008 - 5:38 pm

    I have been trying to get through to someone at Provider Enrollment at Palmetto for several months! Initially my calls didn’t go anywhere and I would receive a recorded message telling me “All circuits are busy. Please try your call again later.”

    Now when I call I only get a busy signal during business hours. Business hours are supposed to fall between 8-4 PST, but Palmetto actually stops answering the phone at about 3:30!

    This company is completely inept and it is unclear how or why they were given this contract. The other subcontractor was actually efficient and effective and usually fairly easy to deal with.

    Many people I know are refusing to see Medicare patients or they are closing their offices due to the excessive amount of money owed by Palmetto. It is sad and the problem just seems to be getting worse!


    December 18, 2008 - 9:51 pm

    I heard Palmetto is being sued. Any lawyers in California doing this?.

  • Dr. Ballard

    June 5, 2009 - 7:38 pm

    I have billed Medicare for over 25 years without a problem. Now, I only have one client on medicare, but I cannot get approval for the previously approved payments…It’s been over a year and each denial is a “different” reason….they are not addressed in one response….One has to rebill over and over; the last one was “writing not neat enough”. I am so fed up I am seeing my client for free as he has serious depression with lifethreatening medical condition…I think this is what they wanted!!!! And Obama plans to use the Medicare plan for National Health. Woe is us………………..

  • Lisa

    September 22, 2010 - 11:17 am

    We need the option to return to NHIC. Our office now has two people dedicated to Medicare billing through Palmetto… ridiculous! I recently read on another sight there are a multitude of other problems including a failed conversion of the NPI crosswalk file that mysteriously dropped off 25% of Medicare providers from the list to the backlog of over 26000 pending providers’ applications. That had to have been another one of our problems because we had several phone calls where we weren’t “in the system” first as individuals in a practice then as a group practive.
    This has been an absolute nightmare and we should have the option to change back to NHIC.

  • Patricia Tinsley

    October 11, 2010 - 8:48 am

    I have been waiting for weeks to get re-imbursed for a doctors visit. My doc. requires
    money up front. I have the statement from my
    doctor, and it shows that the bill has been sent
    5 times, and sent back with no explaination at all from Medicare, What in the hell is going on?
    Is this another gov’t screw up???

  • admin

    October 25, 2010 - 11:12 am

    Lisa: Have your office re-validate your information to get into Pecos? If not, I would suggest you do so quickly. This involves completely filling out form 855 but will solve the problem of not being ‘in the system’. Don’t forget to send in form 588 for EFT if your payments are not currently being electronically deposited.
    I wish going back to NHIC was an option. Can only hope Palmetto will get better. Thank you for sharing.

  • admin

    October 25, 2010 - 11:15 am

    Patricia: Sounds more like the errors might be happening from your doctor’s office. Fortunately, all Medicare billings are done electronically so once ‘properly setup’, it goes pretty smoothly.

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