FISS Narrative
Services fall within or overlap a Medicare Advantage (MA) Health Maintenance Organization (HMO) enrollment period.

Explanation and Suggestion:
Inpatient claims must be submitted with a condition code 04 when a patient is enrolled in a MA Plan for benefit tracking purposes.

Always check eligibility prior to submitting claims:

  • Direct Data Entry (DDE)
  • Interactive Voice Response (IVR)
  • Palmetto GBA's eServices
  • Verify beneficiary’s admission date, 'from' and 'through' dates on claim
  • Compare dates with MA enrollment

Contact Palmetto GBA JM Part HHH Medicare

Email HHH

Contact a specific JM HHH department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC


National Supplier Clearinghouse MAC


RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries



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