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.
© 2020 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
This job aid was created to assist Part A and home health and hospice providers in completing and understanding the address sections of the CMS-855A enrollment application. In the charts below you will find the CMS-855A address with each Palmetto GBA department.
(Corresponding Fiscal Intermediary Shared system [FISS] Address Field Title)
(FISS: Other Address)
(FISS: Master Address)
CMS-855A: Section 4 B, Remittance Notices or Special Payments Mailing Address
(FISS: Remit Address, Check Address)
Other Mailing Addresses
On the CMS-855A Enrollment Application, the address sections are:
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: 12/05/2019