Eligibility

Use Palmetto GBA’s eServices tool to access beneficiary eligibility information, including the effective date of a patient’s Medicare benefits such as hospice enrollment and whether the patient is enrolled in fee-for-service (original) Medicare or a Medicare Advantage plan.

All providers that have an Electronic Data Interchange (EDI) Enrollment Agreement on file may register to use this tool. Simply access the introductory article to learn more by clicking on the ‘eServices’ link in the top toolbar. Please view the eServices User Manual (PDF, 7.78 MB) for information on enrollment. 

One Important Consideration
Only one provider administrator per EDI Enrollment Agreement/PTAN/NPI combination performs the registration process. Billing services and clearinghouses should contact their provider clients to gain access to the system.

Palmetto GBA providers can also access Medicare patient eligibility information by phone through our Interactive Voice Response (IVR) system. Some providers can directly access their shared processing system using Direct Data Entry (DDE) or Professional Provider Telecommunications Network (PPTN) systems to retrieve eligibility information. Available options are listed below for each contract:

JJ Part A

Home Health and Hospice

JM Part A

JM Part B

Railroad Medicare