EDI Enrollment Status Online Request Form

Palmetto GBA is pleased to offer an online process to request the status of the processing of your EDI Enrollment forms. The linked online form can be used to request status information for any one of the following EDI enrollment options:

  • EDI Enrollment Tracking
  • EDI Enrollment Agreement
  • Claims Submission Enrollment
  • Electronic Remittance Linkage

EDI Enrollment Tracking

The Palmetto GBA EDI Operations Department will send a tracking number via email once your EDI Enrollment request has been processed. See sample below.

Your request for the following: "EDI ENROLLMENT FORMS" has been received. The following tracking # has been assigned to your request:
 
TRACKING #: [TRACKING NUMBER] for [PROVIDER NAME] [PROVIDER EMAIL]
 
Please allow 48 hours before checking the status of your request. Visit the Palmetto GBA website periodically at
http://www.palmettogba.com/internet/EDITrack.nsf for the status of your request. Processing times may vary upon request type.

If you are a Railroad Medicare submitter and have a question about your status, please call 888-355-9165.

If you are a Part A, Part B or HHH submitter and have a question about your status, please  call 855-696-0705.

To request a status update of your EDI Enrollment form, please click on the link from your email or the link below. Enter your Tracking Number and you will immediately receive status information regarding your EDI request. The EDI Enrollment Tracking Comments Chart is a listing of all enrollment approval and rejection messages. If your forms were rejected, please correct and resubmit.

 

EDI Enrollment Agreement

To complete the Enrollment Agreement portion, enter the PTAN (Provider ID) on the form and it will return an enrollment date for this PTAN (Provider ID) if this provider is enrolled with EDI.

Claims Submission Enrollment

To complete the Claims Submission portion, enter the PTAN (Provider ID) and the Submitter ID on the form and it will return an enrollment date for claims submission linkage. Note: The Claims Submission Date is an approximation of the date that the Submitter ID and PTAN (Provider ID) were linked for claims submission. This date may actually have occurred prior to the date listed. If Submitters are able to currently submit for this PTAN (Provider ID), please continue to do so.

Electronic Remittance Linkage

To complete the Electronic Remittance Linkage, enter the PTAN (Provider ID) and the Submitter ID/Receiver ID on the form and it will return an enrollment date for electronic remittance linkage. Note: This linkage can only occur for one Submitter ID/Receiver ID. A PTAN(Provider ID) cannot have multiple linkages for electronic remittances.

To request a status update for these items, please click on the link below and select the appropriate option. The above statuses are only produced if paperwork has been submitted for a PTAN (Provider ID) to the Palmetto GBA EDI Operations department and 20 business days has elapsed for processing of the request. Please allow 48 hours for enrollment completion before submitting claims or retrieving remittances.

Palmetto GBA EDI Tracking Form

If you are a Part A, Part B or HHH submitter and have a question about your status or do not receive a response about your status, please contact the Palmetto GBA Provider Contact Center at 855-696-0705 (JM) or 877-567-7271 (JJ).

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

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Jurisdiction J Part A MAC

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Jurisdiction M Home Health and Hospice MAC

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National Supplier Clearinghouse MAC

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