JM Palmetto GBA: West Virginia Medicare Part B
Palmetto GBA administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction M, which includes the state of West Virginia. If you are a provider located in the state of West Virginia and need to become an electronic submitter for your Medicare B claims, please follow the enrollment instructions below.
Please Note: Palmetto GBA has subcontracted with National Government Services (NGS) to continue EDI support of the Vriginia and West Virginia Part A workload for Jurisdiction M. Please visit the link to the right "NGS Medicare: Virginia Part A" if you need to send claims for that line of business.
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. Palmetto GBA EDI Enrollment Packet
If the link above does not work properly, please download this packet from the website by going here:
Choose one of the Jurisdiction M links under Topics choose EDI, then EDI Enrollment
If you have any questions regarding any of the documents in this package, please phone the Palmetto EDI Technology Support Center at 855-696-0705.
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 JM and JJ Part A|
VBJ0070 for JM and JJ 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|
- Select your Line of Business
- New Applicants, please choose “Apply for New Submitter ID”
- New Applicants, please leave the Submitter ID and Receiver ID lines blank
- Please enter today's date
- Enter your company or provider name as Submitter 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.
- Vendor ID:VS4148 for JM and JJ Part AVBJ0070 for JM and JJ Part BVR1158 for Railroad Medicare
- For name of Network Service Vendor please enter ClaimShuttle by Axiom Systems
- 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 service also select “Online Inquiry Services”
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 enter the Providers Tax ID
- 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
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 access please ask us about our ClaimShuttle service! We can have you logged in to your FISS/DDE 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.
Submit the enrollment forms reflecting original signatures to:
Part B Fax: 803-699-2430
Part B Email: EDIEnroll.PartB@PalmettoGBA.com
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 up to twenty business days from the date of receipt.
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 855-696-0705.
Once you have received your Submitter ID and password from Palmetto, please call the SolAce Support Team at 602-439-2525 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.
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.
SolAce is awesome software. I absolutely LOVE it. For over three years I have used this software daily for multiple long term care facilities to submit claims to various MACs, Medicaid, and Medicare Advantage and Supplemental Insurance carriers. It is convenient, simple to use and far less costly than any Clearing House software I had explored. The ability to import from my Practice Management Software and Therapy Providers has reduced any RTP claims edits and denials are a thing of the past. Customer Support is “Johnny on the spot”, but terrific as they may be, it gets better - RARELY do I need to call. LOVE IT, LOVE IT, AND LOVE IT.
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.
SolAce has been a valuable tool that has been a life saver for my billing service for years. It has allowed me to bill professional and institutional claims with ease. Customer service @ SolAce is top rated in my opinion. The SolAce product is very user friendly and affordable. Thank you SolAce team for a great product.
Easy to use, Customer support has always been excellent, Thanks SolAce Team.
I am a new client and was having a tough time getting everything set up just right. I had to make calls to CEDI and when I called back the rep I spoke with prior even helped the 2nd rep to make sure I got all the info I needed. They definitely work as a team. Within a short period of time they had my system up and running. I never could've done it without them.
Awesome customer service every time!
I can't tell you how wonderful it is to work with your agency. They are courteous, knowledgeable,friendly, and a joy to work with - I can't say enough. Thank you!!
The service was very good. Phone answered promptly even though it was around 6 p.m. my time. Very courteous and helpful. So far I have had really good experiences with your support team.
The follow-up is outstanding - whenever there is an issue I am contacted to be sure that all is working well and to my satisfaction.
Everyone in your company is very helpful and pleasant, and they always have the quickest response time on fixing the situation.
Tech was very helpful, very patient and very professional. She knew of the issue quickly and stayed at hand until issue was resolved. Very satisifed with the service.