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Palmetto Requiring Complete Information on Providers To Update Any Changes

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We called in to Palmetto Provider Enrollment to follow up on an application sent in for one of our provider to change his correspondence address.  We were on hold for 2 hours and when we got thru, we were told that they needed a more completed application. When we asked why do we need to send in complete information on a simple change of address for a provider that has been in the system since 1997, we were told that this is the only way they can update the CMS Pecos System where providers’ profiles reside and this has been a requirement since 2003.

When we asked if this a new requirement since 2003, why didn’t NHIC require this on other providers that we have updated info on before? Loretta in Provider Enrollment glibly answered ‘maybe they weren’t doing things right that’s why they lost the contract’. We promptly advised her that we are a billing service and have been around long enough that we actually made the transition from Transamerica to NHIC which went quite smoothly and they have been processing claims for over a decade without any problems.

Problems have only materialized since Palmetto took over this contract and the transition has been a chaotic bureaucratic farce. If anything, Palmetto underbid the contract and failed to make proper provisions for the transition!

It is bad enough that Palmetto is fumbling this entire contract putting thousands of providers at financial risk with call center delay time, wrongly rejected claims, and delayed payments; It is just plain wrong when they do not take responsibility for their own errors and owe up to their mistakes.


  • Sandra Morris

    December 1, 2008 - 5:57 pm

    My medical provider and I have been trying to get a claim paid since May 2008.
    Medicare claimed sometime after Palmetto’s contract began that Medicare had not changed providers; then I was told that they did not have the claim; then I was told that the claim was not properly filled out that information was missing.

  • Virginia Jirjis

    July 6, 2009 - 11:45 am

    When accessing the Interactive Voice system for the PTAN entry (*)asterisk is not working the way it should be. Information on how to enter the PTAN via access (*) does not work.

    Also we received a letter for Paper Claims Submission Practices as we did apply for paper claim waiver but all claims submitted has been rejected even if we attached the WAIVER. How can our claim be paid.

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