J11 Palmetto GBA: South Carolina Medicare

Palmetto GBA administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdictions 11, which includes the state of South Carolina. If you are a provider located in the State of South Carolina and need to become an electronic submitter for your Medicare A/B Claims, please follow the enrollment instructions below. 

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed and returned to the Palmetto office prior to initiation of electronic claims submission or inquiry.

  1. J11 Palmetto GBA EDI Enrollment Packet

If the link above does not work, please open the packet from Palmetto's site directly by going here: http://palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~JM%20Part%20B~EDI~Enrollment~89BLL31745

If you have any questions regarding any of the documents in this package, please phone the Palmetto EDI Technology Support Center at 866-749-4301.

NOTE:

VA & WV Part A - Palmetto GBA has subcontracted with National Government Services (NGS) to continue EDI support of the Virginia and West Virginia Part A workload for Jurisdiction 11 A/B MAC. Please visit the NGS website or contact the NGS Help Desk at 1-877-273-4334 for EDI support once you begin submitting Production claims.

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

Our Vendor Information

Vendor Name - AXIOM Systems, Inc.
Contact - EDI Team
Vendor Code - VS4148 for J1 and J11 Part A
VBJ0070 for J1 and J11 Part B
VR1158 for Railroad Medicare
Phone - 602-439-2525
Fax - 602-439-0808
Address - 241 East 4th Street, Suite 200
Frederick, MD 21701
Software Name - SolAce EMC
E-mail - Support@SolAce-emc.com

J11 EDI Application

  • Select your Line of Business
  • New Applicants, please choose “Apply for New Submitter ID”
  • If you would like to receiver your EOBs electronically from Palmetto, please also select “Apply for New Receiver ID”
  • New Applicants, please leave the Submitter ID line blank.
    • If you are already an existing electronic submitter and you are just applying for a new Receiver ID to receive electronic EOBs from Palmetto please enter your current Submitter ID.
  • Enter your business name as Submitter name and enter the owners name
  • If you are applying for your OWN submitter ID please select “Provider”. If you are a Billing Service, please select “Billing Service”
  • Complete the EDI contact person section with your information
  • Report Response Format choose File
  • Data compression: choose PKZIP
  • Name of Software Vendor: AXIOM System’s Inc. formerly Ivertex
    • Vendor ID = VS4148 for J1 and J11 Part A, VBJ0070 for J1 and J11 Part B, and VR1158 for Railroad Medicare
  • Please complete the ‘Providers for Whom Submitter Will be Transmitting” with your Provider’s information and choose the following options:
    • Enrollment Form Attached: Yes
    • Provider Authorization Form Attached: Yes (If you are a provider billing through a Billing Service, otherwise leave blank)
    • Mark: Submit claims, Receive Reports, Receive Electronic Remittances
    • If you want to apply for a separate ID for the online FISS/DDE or PPTN service also select “Online Inquiry Services” J11 Electronic Data Interchange Enrollment Agreement Each provider must complete Section C. of this form and enter his/her Medicare Provider number and NPI.

Provider Authorization Form

Providers who wish to authorize a Billing Service the authority to submit claims electronically would fill out this form, if not please skip.

  • Select the proper Line of Business
  • Indicate the type of service(s) you are authorizing the Submitter (billing service) to access
  • Enter the Provider’s name for which the form is being completed.
  • Note: The name must match the name submitted on the CMS 855 Medicare Enrollment Application
  • Please provide the Providers Email address for all EDI notifications
  • List the Providers PTAN, a separate Provider Authorization form is required for each PTAN
  • Enter the Provider’s NPI
  • List the name and title of the person Palmetto will contact for questions regarding this form
  • Enter the demographic information of the Provider
  • Enter the name of the Submitter you are authorizing (billing service/clearinghouse)
  • The Provider must sign and date the application

Please skip the J11 Software Order Form sections

If you marked off the “Online Inquiry Services” option on the forms above, please complete the J11 Direct Date Entry Form. Otherwise, you may also skip this entire section.
Part A Providers are required to have access to the DDE System. If you need a Network Service Vendor that will provide the connection for your FISS/DDE and/or PPTN access please ask us about our ClaimShuttle service! We can have you logged in to your FISS/DDE or PPTN screens in no time!

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:

Palmetto GBA EDI
J11 EDI Operations, AG-420
PO Box 100145
Columbia SC 29202-3145

It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately twenty business days from the date of receipt. (Remember that mailing time can take as much as five days.)

After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after 20 business days, contact Palmetto EDI Technology Support Center at 866-749-4301.

Testing

Once you have received your Submitter ID and password from Palmetto, please call the SolAce Support Team and set an appointment for a Mailbox setup and Test Transmission to Palmetto.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.

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customers From our customers

I am very pleased with our SolAce billing software and how easy it is to navigate. They have a great team who can train you to do billing even if you don’t have billing experience. Special thanks to Cathy, Gigi, and Skyler who always helps me out every time I have issues.

Shani Madaminova,
Administrator
Best Home Care, Inc
Jersey City, NJ

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Susie Doran Carter, Westcare Management, Inc.
LTC Medicare Consultant and Billing Service
Salem, OR

I think our medical office was one of the first to use SolAce in the mid 1990’s and we are still using it today for all of our electronic billing because it works ! It was simple for our staff to learn and it integrated easily with our accounting/billing program. It has been especially nice to know that the Axiom staff is there when Medicare changes something and they are right on it. They made the 5010 change a simple process plus made educational seminars available to us. Thank you to all the Axiom/ Ivertex professionals who have helped us for the last 15+ years.

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From the office of Donald J. Boles Jr. MD PC
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IT Administrator
THE WYNN GROUP, INC
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