Find answers to frequently asked Medicare questions below. 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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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 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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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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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 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 JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department


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