Palmetto GBA Medicare Electronic Data Interchange (EDI) is pleased to offer online enrollment for Direct Data Entry (DDE) for Medicare Part A. DDE allows you to key and send claims; correct, adjust and cancel claims; inquire about the patient's eligibility; access the Revenue Code, HCPCS Code and ICD-9 Code Inquiry tables; access the Reason Code and Adjustment Reason Code inquiry tables; and determine DRG for Inpatient Hospital Claims.
Note: You (your facility) must have been issued a Submitter ID prior to completing this request form.
To complete the Online DDE Enrollment Form, please follow these instructions:
- Complete all required fields as indicated by an asterisk
- The Company Name, Address & Contact Information fields should be the entity associated with the Submitter ID. For example, if a billing service or clearinghouse will be accessing DDE on behalf of a provider, please include the billing service or clearinghouse information in the Company Name, Address & Contact Information fields. Provider information is requested at the bottom of the form. If the Provider will be accessing DDE directly, enter the Provider information in the Company Name, Address & Contact Information fields.
- Select which line of business, either Part A of South Carolina(SE/SW), Part A of North Carolina or Part A of Gulf Coast/Midwest (GCMW)
- Remember that there is a monthly charge of $25 for each DDE ID assigned
- Select Providers/Corp Headquarter or Billing Service/Clearinghouse by clicking on the appropriate radio button.
- Enter all applicable provider number(s) to be added. If you are requesting access to more than 10 providers, please enter the first 10 provider numbers and click Submit. Once you have submitted the first group, you may click the Back button on your Internet browser, change the provider numbers and click Submit again. Remember to record your Request ID Number after each submission.
- Record your Request ID Number after each submission. If you do not receive a Request ID Number after clicking Submit, you may click the Back button on your Internet browser to enter corrected information in all fields.
Online DDE Enrollment Form