Electronic Data Interchange (EDI)

Published 12/01/2016


Palmetto GBA's Electronic Data Interchange (EDI) division encourages providers to submit their claims electronically and to utilize certain electronic features we offer. You can also access certain claim and patient eligibility records, and retrieve your remittance notices electronically.

The Centers for Medicare & Medicaid Services (CMS) has approved version 5010 Base and Errata as the exclusive version for all ASC X12N electronic transaction sets used by Medicare. ASC X12 TR3 Implementation Guides for v5010 transactions are available through the ASC X12 Store.

Please contact the Palmetto GBA Provider Contact Center at 855-696-0705 for EDI-related assistance. You may also email us by clicking on Contact Us at the top of this page.


-
Approved Network Service VendorsHow to Avoid Common Version 5010 Claims RejectionsHealth Care Provider Taxonomy Codes (HPTC) InformationNetwork Service AgreementPart B PC-ACE Pro32 Reference GuideTraining Modules on v5010 ReportsPC-ACE Pro32 Training ModulesPart B Approved 5010 Errata Vendors999 and 277CA Response ReportsClaim Status Category Code and Claim Status Code UpdatePC-ACE Pro32 Software User ManualOnline ERA /ERN and GPNet Report Restore FormIntroduction to PC-ACE Pro32ASC X12 270/271 Beneficiary Eligibility InquiriesASC X12 v5010 Medicare Fee-For-Service Standard Companion Guides277CA Edit Lookup ToolMedicare Fee-For-Service Part B Common Edit and Enhancements Module (CEM) EditsCMS-1500 to 837 v5010A1 CrosswalkGPNet Communications ManualASC X12 v5010 Resources At-A-GlanceEDI Enrollment Status ToolASC X12 837 v5010 Errata Testing ProceduresJurisdiction M Part B EDI Enrollment FormsInformation to Have Available When Contacting the EDI DepartmentMedicare Secondary Payer (MSP) Electronic Claim Filing RequirementsPart B & RR Electronic Claim TipsEDI Enrollment Instructions Guide ModuleMedicare Remit EasyPrint (MREP) Software for Part BJM Part B EDI Online Enrollment FormsPC-ACE Pro32 Version 5.3 Update FileSmart Edits Listing and 277CA EnhancementPC-ACE Pro32 Version 5.4 Update FilePC-ACE Pro32 Software Download for JM Part B ProvidersJM Part B EDI Enrollment: Finding Forms OnlineWhat information do I need to have available when calling for Electronic Data Interchange (EDI) assistance?Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description?What provider address should I include on the EDI enrollment forms?What Submitter Name should I enter on the Provider Authorization form?What is a Network Service Vendor?When is a provider authorization form required?What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group?What is an approved software vendor?Is the 277CA returned for each test submission?PC-ACE Pro32 Software FAQHow do I restore a remit file?How can I tell if I am set up for Electronic Billing?After I receive a 277CA will I receive anything else?