RHCs Serviced by Cahaba


RHCs Serviced by Cahaba

As you should have heard, Cahaba has lost their contract as a Medicare Administrative Contractor (MAC) for Jurisdiction J (JJ) (Alabama, Georgia, Tennessee). The new contractor for MAC Region J (JJ) will be Palmetto GBA.

Jurisdiction J (JJ), in addition to handling Medicare Part A and B claims for the three states mentioned above, was also the “legacy” MAC for hundreds of RHCs located outside of Jurisdiction J (JJ). This is a link to an FAQ document produced by Palmetto GBA intended to answer questions from providers (hospitals, physicians, RHCs, etc.) affected by this change.

You are encouraged to review the entire document; however, there are two questions of specific interest to the RHC community that I have reproduced here:

Questions: I am with a RHC in Illinois, currently Jurisdiction J (JJ), submitting to Cahaba. Will we be included in the 01/28/18 transition date?

Answer: Yes, any current Jurisdiction J (JJ) providers with Cahaba GBA will transition to Palmetto GBA.

Question: Since Rural Health Clinics (RHCs) submit two claims, one to Part A on the UB04 claim form and one to Part B in the 1500 claim form, how will we submit our claims since Part A transitions in January and Part B transitions in February?

Answer: To submit claims for an RHC visit after Part A has transitioned to Palmetto GBA but Part B has not, you will submit the Part A claim to Palmetto GBA and the Part B claim will still be submitted to Cahaba GBA for processing.

If you are affected by this change and you have questions, you are encouraged to reach out directly to Palmetto GBA staff.

To download the Palmetto GBA Provider Outreach & Education Speaker Request Form Click Here.