Palmetto GBA: In 2020, RR Medicare ID requirements change

Published: December 26, 2019

A message from Palmetto GBA:

Whether you’re new to Railroad Medicare or starting a new year with Railroad Medicare, it’s important to know about the change to how Medicare identifies you.

In 2020, Medicare providers must use your new Medicare number. The old Social Security-based number can no longer be used for claims filing, no matter what date your provider furnished a service to you. This means if you had a doctor’s visit on January 15, 2019, the provider must file the claim before January 15, 2020 and they must use your new Medicare number. If your provider does not have your new number, you need to give that to them. Claims filed without the new number will be rejected by Medicare and cannot be processed for any payment.

If the provider is not able to get with you to get your new number, they can use our Medicare number lookup tool on our website. We would hope this would be the exception, not the norm. In order to use the Medicare lookup tool, the provider must have your Social Security number (SSN). If you do not want to give your SSN to a provider, make sure to show them your Medicare card with your new Medicare number.

Additionally, you will also need to use your new Medicare number if you call customer service at Railroad Medicare or 1-800-MEDICARE. Medicare contractors cannot accept any other form of identification over the telephone or in writing.

Here are the details about new Medicare number:

  • It will have 11 characters.
  • The numbers will be generated randomly. Medicare considers them ‘non-intelligent’ numbers that don’t have any hidden or special meaning.
  • It will be unique to each patient.
  • It will contain capital letters (all letters with the exception of S, L, O, I, B and Z) and numbers (0-9).
  • The 2nd, 5th, 8th, and 9th characters will always be a letter, while characters 1, 4, 7, 10, and 11 will always be a number. The 3rd and 6th characters will be a letter or a number.
  • There will be no dashes in the numbers on the card.

As you may have experienced in the past, providers can’t always tell the difference between a Social Security Medicare patient and a RRB patient. They may submit your claims to regular Medicare instead of Railroad Medicare. To help providers know what patient they have, the new cards will have the RRB logo on them when applicable, so your doctor’s office will know where to submit claims. Your provider can also use an online portal if they have your Medicare number but don’t know if it’s a Railroad Medicare number. We educate providers on our portal regularly, but some may not be aware.

If you have a provider who may be confused, have them call our Provider Contact Center at 888-355-9165. Customer service representatives are available 8:30 a.m. to 4:30 p.m. Monday through Friday in all time zones with the exception of the Pacific time zone, which receives service from 8 a.m. to 4 p.m. Pacific.