Religious Nonmedical Health Care Institutions (RNHCI) Tip

Published 11/13/2020

Palmetto GBA will process claims to allow the usage of Lifetime Reserve (LTR) days when the RNHCI daily or TEFRA rate is lower than the LTR coinsurance amount. This means:

  • The RNHCI must submit or adjust their claims with the word 'Exemption' in the Remarks field

  • Palmetto GBA cannot mass-adjust the claims

  • Palmetto GBA will override untimely claims

  • Untimely new or adjusted claims: RNHCI must take into consideration of whether the secondary insurance will also override timeliness. If not, the beneficiary will lose LTR days and be responsible for paying the claim.