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Last Modified: 3/1/2010 Location: FL, PR, USVI Business: Part B

CO 109

Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.

(MISDIRECTED CLAIM FOR RRB BENE. PROV MUST SUBMIT TO PALMETTO GBA)
Resources/tips for avoiding this unprocessable claim
This occurs when a beneficiary is entitled to Medicare through the Railroad Retirement Board (RRB). The RRB provides all Medicare benefits for beneficiaries with “Railroad Medicare.”
Beneficiaries with Railroad Medicare are easily identifiable. All Railroad beneficiary Medicare Health Insurance Claim (HIC) numbers begin with a letter, instead of ending with one.
Example: W123456789
Submit all Railroad beneficiaries’ claims to Palmetto GBA at:
Palmetto GBA
Railroad Medicare Part B
P.O. Box 10066
Augusta, GA 30999
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Source: FCSO Education Action Team