Please Note: There is no Medicare information on our corporate website. Please select a specific contract in the 'Search Within' box for Medicare related information.
© 2021 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
Printed Date: 9/22/2015
Palmetto GBA strives to provide excellent customer service and would like to provide insight into the Certified Provider Enrollment Process. The process detailed below applies to all Part A certified provider types enrolling using the Centers for Medicare & Medicaid Services (CMS) Form 855A, and Part B Portable X-Ray and Ambulatory Surgery Center (ASC) providers enrolling with CMS Form 855B.
The certified enrollment process has three (3) separate and distinct steps.
Step 1 — Submit Application to the Medicare Administrative Contractor (MAC)
Submit your completed CMS Form 855A to Palmetto GBA for review and processing. Upon receipt you will be notified that we have your application and provided with a Document Control Number (DCN) for monitoring the progress of the application using our website or Interactive Voice Response (IVR) system.
A complete review of your application will be completed and there are deficiencies or missing supporting documentation a development letter will be issued to the contact person identified on the application. Requested information should be provided back to Palmetto GBA within 30 to prevent the application from being rejected for non-response.
Once application processing is completed, we will issue a recommendation for approval letter to your local State Agency (SA) and the appropriate CMS Regional Office (RO).
Step 2 — State Agency Processing
The state will:
Once the state completes its review process, a completed packet will be sent to the Regional Office (RO) for review and final approval.
Step 3 — CMS Regional Office Issues Approval
The Regional Office (PDF, 48 KB) verifies with the state that there are no deficiencies and evaluates eligibility to participate in the Medicare Program. If approval is granted, the RO will issue a Tie-In to Palmetto GBA and simultaneous notification to the provider. Please note that you must await formal notification from Palmetto GBA before you can submit claims. An approval letter will be issued by Palmetto GBA letting you know the enrollment process is complete, at which time you may proceed with enrolling in EDI (Electronic Data Interchange) to submit your claims electronically.
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 10/29/2020
We've recently uppgraded our website and it looks you're trying to access an old link. Please select an option below.
Attempt to load this page on new site
Go to Home page
Go to Contact Us page
View a related article: