Electronic Data Interchange (EDI)

Published 07/12/2022

Palmetto GBA's Electronic Data Interchange (EDI) division encourages providers to submit their claims electronically and to utilize certain electronic features we offer. You can also access certain claim and patient eligibility records, and retrieve your remittance notices electronically.

The Centers for Medicare & Medicaid Services (CMS) has approved version 5010 Base and Errata as the exclusive version for all ASC X12N electronic transaction sets used by Medicare. ASC X12 TR3 Implementation Guides for v5010 transactions are available through the ASC X12 Store.

Please contact the Palmetto GBA Provider Contact Center at 877–567–7271 for EDI-related assistance. You may also email us by clicking on Contact Us at the top of this page.

How to Avoid Common Version 5010 Claims RejectionsHealth Care Provider Taxonomy Codes (HPTC) InformationNetwork Service AgreementNetwork Service Vendors (NSVs) for JJTraining Modules on v5010 ReportsPart B PC-ACE Pro32 Reference GuideClaim Status Category Code and Claim Status Code Update999 and 277CA Response ReportsPC-ACE Pro32 Software User ManualIntroduction to PC-ACE Pro32Online ERA /ERN and GPNet Report Restore FormASC X12 270/271 Beneficiary Eligibility InquiriesASC X12 v5010 Medicare Fee-For-Service Standard Companion Guides277CA Edit Lookup ToolJJ Part B Approved 5010 Errata VendorsPC-ACE Pro32 Training ModulesMedicare Fee-For-Service Part B Common Edit and Enhancements Module (CEM) EditsEDI Enrollment Status ToolCMS-1500 to 837 v5010A1 CrosswalkGPNet Communications ManualASC X12 v5010 Resources At-A-GlanceASC X12 837 v5010 Errata Testing ProceduresJurisdiction J Part B EDI Enrollment FormsInformation to Have Available When Contacting the EDI DepartmentMedicare Secondary Payer (MSP) Electronic Claim Filing RequirementsPart B & RR Electronic Claim TipsMedicare Remit EasyPrint (MREP) Software for Part BJJ Part B EDI Online Enrollment FormsPC-ACE Pro32 Version 5.3 Update FileSmart Edits Listing and 277CA EnhancementPC-ACE Pro32 Version 5.4 Update FilePC-ACE Pro32 Software Download for JJ Part B ProvidersJJ Part B EDI Enrollment: Finding Forms OnlineWhat information do I need to have available when calling for Electronic Data Interchange (EDI) assistance?Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description?What provider address should I include on the EDI enrollment forms?What Submitter Name should I enter on the Provider Authorization form?What is a Network Service Vendor?When is a provider authorization form required?What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group?What is an approved software vendor?Is the 277CA returned for each test submission?PC-ACE Pro32 Software FAQHow do I restore a remit file?How can I tell if I am set up for Electronic Billing?After I receive a 277CA will I receive anything else?PC-ACE Pro32 Version 5.5 Update FileEDI Enrollment Instructions Guide Module