OTPs Introduction to Railroad Medicare

Opioid Treatment Programs (OTPs): Introduction to

Railroad Medicare

Railroad Retirement Board Specialty Medicare Administrative Contractor (RRB SMAC)

Provider Outreach and Education December 19, 2019

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Disclaimer

The information provided in this presentation was current as of December 19, 2019. Any changes or new information superseding the information in this presentation are provided in articles and resources with publication dates after December 19, 2019, posted on our website at: RR. Medicare policy changes frequently so links to the source documents have been provided within the document for your reference.

This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations. Although every reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services.

The Centers for Medicare & Medicaid Services (CMS) and the Railroad Retirement Board (RRB) employees, agents, and staff make no representation, warranty, or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide .

This publication is a general summary that explains certain aspects of the Medicare Program, but is not a legal document. The official Medicare Program provisions are contained in the relevant laws, regulations, and rulings.

CPT? codes, descriptors and other data only are copyright 2019 American Medical Association. All rights reserved.

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Acronyms

ACRONYM NPI PTAN TIN HICN MBI EDI IVR SAMHSA

OUD

DESCRIPTION National Provider Identifier Provider Transaction Access Number Tax Identification Number Health Insurance Claim Number Medicare Beneficiary Identifier Electronic Data Interchange Interactive Voice Response Substance Abuse & Mental Health Services Administration Opioid Use Disorder

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Agenda

? Who We Are and What We Do ? Getting Started with Railroad Medicare ? Provider Enrollment ? Go Paperless - EDI, ERA and EFT ? Claim Submission ? Interactive Voice Response System (IVR) ? eServices Provider Internet Portal ? Claim Payment, Rejections and Denials ? Medical Review and Documentation Requests ? Appeals and Reopenings ? Your Questions

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