FAQs

Find answers to frequently asked Medicare questions below. You can view additional FAQs for Hospice providers on the CMS website. For help with eServices, view our eServices FAQs.


After I receive a 277CA will I receive anything else?

Answer:
If you receive a 277CA, you will not receive another EDI report.

This was last updated on 09/28/2020

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Can I share my DDE ID?
Each user must have an individual DDE number. For security reasons, you cannot share your DDE ID number or transfer the ID to another person. If an individual leaves your company or no longer needs access, please contact EDI to delete the ID. One DDE ID can access multiple provider numbers.

This was last updated on 09/28/2020

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How can I tell if I am set up for Electronic Billing?

Answer:
Please use the EDI Enrollment Status Online Request Form located under EDI, Enrollment for you contract. 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 EDI Provider Contact Center at 855-696-0705 (JM) or 877-567-7271 (JJ) to verify EDI Enrollment.

This was last updated on 09/28/2020

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How do I reset my DDE password?
Please refer to Section 1.B.4 in the DDE User's Guide.

This was last updated on 09/28/2020

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How do I restore a remit file?

A remittance file can be restored to your mailbox by submitting an Online ERA/ERN and GPNet Report Restore Form. You will receive a request confirmation by email. The remittance files are available 20 business days prior to current date. You may also contact our EDI Provider contact Center at 855-696-0705 (JM), 877-567-7271 (JJ) or 888-355-9165 (RR) for assistance with restoring your file. 

Please have your Submitter/Receiver ID, Dates to Restore, Check/EFT number, Check/EFT Amount, Email Address and Contact Phone Number ready before submitting a request. Palmetto GBA can only restore remit files for a submitter or if receiving files from a clearinghouse, the contact on file with EDI.

This was last updated on 09/28/2020

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If I have an existing DDE ID with another company, can I request a new ID?
No, one DDE ID can access multiple provider numbers.

This was last updated on 09/28/2020

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Is the 277CA returned for each test submission?
Answer:
You will receive a 277CA after you receive an approved 999.

This was last updated on 09/28/2020

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Is the Submitter ID required on the DDE enrollment form?
Enter the Submitter ID if available.

This was last updated on 09/28/2020

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PC-ACE Pro32 software FAQs

What is Pro32 software and does it cost anything?
Answer:
The PC-ACE Pro32 software is a claims-entry software available from Palmetto GBA at no cost. It cannot be used in conjunction with any other software.

What do I need to do to utilize the Pro32 software? Where do I start?
Answer:
If you currently have a submitter ID, you can download the PC-ACE Pro32 software from our website under the EDI, Software & Manuals page for your contract.

Once I download the PC-ACE Pro32 software, is it an easy process?
Answer:
Yes. Please use the PC-ACE pro32 User’s Manual and the PC-ACE Pro32 Reference Guide along with the confirmation sheet you received. The PC-ACE Pro32 training modules are designed to address the basic information you will need to know to submit a claim electronically. You can view the PC-ACE Pro32 training modules from our website under the EDI, Software & Manuals page for your contract.

Do we have to manually enter each claim into the Pro32?
Answer:
Each claim must be manually entered. Pro32 cannot accept claims transferred from another software program. Please refer to the Pro32 user's manual, as well as Pro32 Training Module 3A (Part A claims) or 3B (Part B claims) for additional information.

This was last updated on 09/28/2020

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What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance?

Answer:
Please have the following information available prior to calling about an EDI-related issue so we may assist you:

  • Provider Transaction Access Number (PTAN), also known as a provider number, or your National Provider Identifier (NPI)
  • Company name
  • Contact name
  • Telephone number
  • City and state
  • Submitter ID
  • File ID
  • Error Message

If you are unable to provide this information, you may be required to call back.

This was last updated on 09/28/2020

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What is a Network Service Vendor?

Answer:
A Network Service Vendor provides high speed, secure connectivity to submitters for claim submission and responses. Please refer to a listing of
CMS Approved NSVs (PDF, 63 KB).

This was last updated on 09/28/2020

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What is an approved software vendor?

Answer:
An approved software vendor has completed and passed all 5010A1 or 5010A2 test requirements.

This was last updated on 09/28/2020

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What is the difference between a Submitter ID and a DDE ID?
A Submitter ID is used to transmit EDI transactions to Palmetto GBA. A DDE ID is used to access the Direct Data Entry (DDE) claims processing system to enter claims on-line.

This was last updated on 09/28/2020

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What provider address should I include on the EDI enrollment forms?
The address on the EDI enrollment forms must match the address that was submitted to our provider enrollment department when enrolling for a provider number. If the address on the completed EDI enrollment form does not match, your entire EDI enrollment packet will be rejected.

This was last updated on 09/28/2020

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What provider name should I include on the EDI enrollment forms?
The provider name must match the name submitted on the Medicare provider enrollment application.

This was last updated on 09/28/2020

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What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group?
The group PTAN (provider number) and group NPI must be submitted on all EDI enrollment forms when a provider is a member of a group. If a provider is a member of a group, only one agreement is required.

This was last updated on 09/28/2020

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What Submitter Name should I enter on the Provider Authorization form?
Enter the name of the Submitter you are authorizing to submit and/or receive electronic data on your behalf. The Submitter Name must match the Submitter Name on the EDI Application.

This was last updated on 09/28/2020

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When is a provider authorization form required?
Every provider who authorizes a billing service and/or clearinghouse to act on their behalf must complete the provider authorization form. This form must be completed by the provider and submitted with the EDI application.

This was last updated on 09/28/2020

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Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description?
Answer:
The STC segment will include the health care claim status. Please review the CEM 837 Institutional Edits (PDF, 2.43 MB) and CEM 837 Professional Edits (PDF, 2.22 MB) listings
.

This was last updated on 09/28/2020

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Will you reject claims with a P.O. Box in the billing provider address? Will you reject claims where the group number and policy number are the same values?
Answer:
Palmetto GBA will reject claims with a P.O. Box in the billing provider address. Effective October 1, 2012, the group number cannot be submitted.

This was last updated on 09/28/2020

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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

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

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