Palmetto GBA may request additional information from you in order to process your submitted claims. These letters, also called 'additional development requests,' require actions on your behalf and may be time sensitive. It is very important that you advise your staff of the urgency of responding to such requests from Palmetto GBA.
Many times, practices find that they need to change the 'correspondence address' that Palmetto GBA has on file. Updating your correspondence address is easy. It does require provider enrollment application submission to the contractor. Depending upon the structure of your practice the following application will need to be completed to advise Medicare of a change in the 'correspondence address.'
- Follow the instructions in Section 1: Basic Information (A and B) to identify the sections of the application that you must complete to change your correspondence address.
Individual Provider –
CMS-855I Application (PDF, 510 KB)
Solo Practitioner –
CMS-855I Application (PDF, 510 KB)
Group or Organization –
CMS-855B Application (PDF, 831 KB)
When updating your information, Centers for Medicare & Medicaid Services (CMS) require that those that do not currently receive payment from Medicare via Electronic Funds Transfer (EFT) elect to do so. You are required to provide EFT information with your updated CMS-855 application. Provide your EFT information on the CMS-588 form. This form is available on the
CMS Web site (PDF, 122 KB)
Mail completed applications to:
J1 MAC - Palmetto GBA
P.O. Box 1508
Augusta, GA 30903-1508
Should you need additional assistance with the completion of your application, please contact us at (866) 931-3901.