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Jurisdiction 11 Part A

Register to receive emails from Palmetto GBA about the latest Medicare news, products and services, special events and more.

Palmetto GBA welcomes your comments and questions. You can get in touch with us in writing, by telephone or via email. Palmetto GBA is the fiscal intermediary for Jurisdiction 11 Part A Medicare Administrative Contractor.

Note: We respond to inquiries in the order in which we receive them. Please allow us time to research your question in order to provide you with the best possible service.

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 Department Contact Information Type of Inquiry

Appeals

Palmetto GBA
J11 Part A Appeals
Mail Code: AG-630
P.O. Box 100217
Columbia, SC 29202-3217
Fax: (803) 699-2425

For Fed Ex/UPS/Certified Mail
Palmetto GBA
J11 Part A Appeals
Mail Code: AG-630
Building One
2300 Springdale Drive
Camden, SC 29020

  • Request for Redeterminations 
  • Redetermination Form 
Beneficiary Customer Service Center

1-800-Medicare (1-800-633-4227)
TTY: 877-486-2048

Visit the Medicare website at www.medicare.gov

  • All questions related to the Medicare program
Claims

Palmetto GBA
J11 Part A Claims
Mail Code: AG-600
P.O. Box 100238
Columbia, SC 29202-3238

  • Request for reopenings
  • Clerical Error Reopening Form    
Cost Report

Cost Report Filing

Mailing Address
Palmetto GBA
Attn: Cost Report Acceptance
Mail Code: AG-330
P.O. Box 100144
Columbia, SC 29202-3144

Fed Ex/UPS/Certified Mail Address
Palmetto GBA
Attn: Cost Report Acceptance
Mail Code: AG-330
2300 Springdale Drive
Building One
Camden, SC 29020-1728

Cost Report Overpayment Address (checks only)
Palmetto GBA
Medicare Finance
Mail Code: AG-260
P.O. Box 100277
Columbia, SC 29202-3277

  • Cost Reports 
  • Checks
Credit Balance Reporting for NC

Regular and Certified Mail
Palmetto GBA
Attn: Credit Balance Reporting
P.O. Box 100278
Columbia, SC 29202-3278

Fed Ex/UPS/Overnight Courier
Palmetto GBA
Credit Balance Reporting
2300 Springdale Drive
Building One
Camden, SC 29020

Reports may be faxed to:
MCBR Receipts
Attn: Credit Balance Reporting
(803) 419-3277

VRU: (803)763-6418

All email inquiries may be sent to Credit.Balance@PalmettoGBA.com

  • Questions or concerns regarding credit balance reports
Credit Balance Reporting for SC Regular and Certified Mail
Palmetto GBA
Attn: Credit Balance Reporting
P.O. Box 100277
Columbia, SC 29202-3278

Fed Ex/UPS/Overnight Courier
Palmetto GBA
Credit Balance Reporting
2300 Springdale Drive
Building One
Camden, SC 29020

Reports may be faxed to:
MCBR Receipts
Attn: Credit Balance Reporting
(803) 419-3277

VRU: (803)763-6418

All email inquiries may be sent to Credit.Balance@PalmettoGBA.com

  • Questions or concerns regarding credit balance reports
Credit Balance Reporting for VA and WV

Regular and Certified Mail
Palmetto GBA
Attn: Credit Balance Reporting
P.O. Box 100109
Columbia, SC 29202-3278

Fed Ex/UPS/Overnight Courier
Palmetto GBA
Credit Balance Reporting
2300 Springdale Drive
Building One
Camden, SC 29020

Reports may be faxed to:
MCBR Receipts
Attn: Credit Balance Reporting
(803) 419-3277

VRU: (803)763-6418

All email inquiries may be sent to Credit.Balance@PalmettoGBA.com

  • Questions or concerns regarding credit balance reports
Electronic Data Interchange (EDI) for NC and SC

Palmetto GBA
J11 Part A EDI
Mail Code: AG-420
P.O. Box 100145
Columbia, SC 29202-3145

EDI Help Desk: 866-749-4301
8 a.m. - 5 p.m. ET

  • EDI enrollment
  • Administrative Simplification and Compliance Act (ASCA)
  • Electronic Remittance Advice (ERA)
  • PC-ACE Pro 32 (billing software)
  • Direct Data Entry (billing software)
  • Other EDI-related issues 
Electronic Data Interchange (EDI) for VA and WV NGS EDI Help Desk: 877-273-4334
  • EDI enrollment
  • Electronic Remittance Advice (ERA)
  • PC-ACE Pro 32 (billing software)
  • Direct Data Entry (billing software)
  • Other EDI-related issues 
Freedom of Information Act (FOIA) Requests

Palmetto GBA
FOIA Coordinator
Mail Code: AG-615
P.O. Box 100190
Columbia, SC 29202-3190

  • FOIA requests
Interactive Voice Response (IVR) System

IVR System: (877) 567-9249

Note: You will be prompted for your PTAN, NPI and TIN.

  • Patient eligibility and claims status (6 a.m. to 6 p.m.) and other transactions are available 24/7
  • Order copies of the Standard Paper Remittance (SPR)
Medical Affairs

Palmetto GBA
J11 Part A Medical Affairs
Mail Code: AG-300
P.O. Box 100238
Columbia, SC 29202-3238

Send emails to
J11A.Policy@PalmettoGBA.com

Fax: (803) 935-0199

  • Local coverage determinations (LCDs)
Medical Review

Palmetto GBA
J11 Part A Medical Review
Mail Code: AG-230
P.O. Box 100238
Columbia, SC 29202-3238

Please call the Provider Contact Center (PCC) at 866-830-3455 for Medical Review questions.

Fed Ex/UPS/Overnight Courier
Palmetto GBA J11 MAC
Mail Code: AG-230
2300 Springdale Drive, Building One
Camden, SC 29020
Fax: (803) 699-2432

  • Responding to Additional Documentation Requests (ADRs)
  • Responses to our requests for medical records
Medicare Secondary Payer (MSP)

For Coordination of Benefits Contractor (COBC) questions, call 800-999-1118 or TTY/TDD at 800-318-8782 for the hearing and speech impaired. Customer Service Representatives are available to provide you with quality service Monday through Friday from 8 a.m. to 8 p.m. ET, except holidays.

Address for general written inquiries:
Medicare - Coordination of Benefits
P.O. Box 33847
Detroit, MI 48232

  • MSP questions
  • Questions regarding beneficiary's primary or secondary records
Overpayments

J11 NC Part A Providers
Palmetto GBA
Medicare Part A Overpayments
Mail Code: AG-340
P.O. Box 100278
Columbia, SC 29202-3277

J11 SC Providers
Palmetto GBA
Medicare Part A Overpayments
Mail Code: AG-340
P.O. Box 100277
Columbia, SC 29202-3277

J11 VA and WV Providers
Palmetto GBA
Medicare Part A Overpayments
Mail Code: AG-340
P.O. Box 100109
Columbia, SC 29202-3109

Provider Inquiries:
For inquiries regarding overpayments, please call the Provider Contact Center at 866-830-3455.

Fax Numbers:

  • To send any financial correspondence to the overpayment department by fax, please fax this information to (803) 419-3275.
  • To request an immediate offset, fax your request to (803) 462-2574.
  • Overpayments
  • Checks for cost report and credit balances
Provider Audit

Palmetto GBA
Provider Audit
Mail Code: AG-320
P.O. Box 100144
Columbia, SC 29202-3144

Palmetto GBA
Cost Report Appeals and Reopenings
Mail Code: AG-380
P.O. Box 100144
Columbia, SC 29202-3144

Email:
Filing of Cost Report Appeals
CostReportAppeals@PalmettoGBA.com

Filing of Cost Report Reopenings
CostReport.Reopening@PalmettoGBA.com

  • Issues related to cost reports, desk reviews, audits and settlements
  • Issues related to the filing of cost report appeals and reopenings
Provider Contact Center (PCC)

Palmetto GBA
J11 Part A PCC
Mail Code: AG-840
P.O. Box 100238
Columbia, SC 29202-3238

IVR-Only Number: 877-567-9249
CSR-Only Number: 866-830-3455

Our PCC Representatives are ready to answer your questions about billing problems and other issues.

J11 Part A PCC Hours: 8 a.m. to 4:30 p.m. ET

Email 
Email J11 Part A to have your inquiry answered. Please do not include any Protected Health Information.

  • General coverage and Medicare-related questions
  • Crossover questions
  • Questions regarding claim filing requirements
  • Explanation of denial reasons
  • IVR resources
  • MSP resources
  • Modifier guidelines
  • Medical record documentation questions
  • Written Inquiries
Provider Enrollment

Palmetto GBA
J11 Part A Provider Enrollment
Mail Code: AG-331
P.O. Box 100144
Columbia, SC 29202-3144

For inquiries regarding provider enrollment, please call the PCC at 866-830-3455

  • Enrollment (credentialing) questions
  • Request CMS-855 B, I or R forms
  • Change address, add a location or add a new member to a provider group
  • Independent Diagnostic Testing Facility (IDTF) enrollment
  • Electronic Funds Transfer (EFT) CMS 588 form
  • Medicare Participating Physician or Supplier Agreement (PAR) CMS 460 form
  • How to obtain a National Provider Identifier (NPI)
  • Participation corrections
  • IRS 1099 tax form corrections
  • Consent forms
Provider Outreach and Education (POE)

Palmetto GBA
J11 Part A POE
Mail Code: AG-830
P.O. Box 100238
Columbia, SC 29202-3238

For education, please complete the Education Request Form. To access this document, go to the Forms Web Page at www.PalmettoGBA.com/j11a/forms

  • Educational training requests
  • Request a speaker for association meetings in your state
 Provider Reimbursement

Palmetto GBA
Provider Reimbursement
Mail Code: AG-330
P.O. Box 100144
Columbia, SC 29202-3144

Phone Number: (803) 382-6104

Fax updated certificates for diabetes education, mammography and PET scan to the reimbursement department at (803) 935-0262.

  • Submission of interim rate information
  • Reimbursement issues
  • Reimbursement specialist
  • Submission of certificates
Zone Program Integrity Contractor (ZPIC)

AdvancedMed Corporation
2636 Elm Hill Pike, Suite 110
Nashville, TN 37214

Phone Number: (615) 872-8600

  • Fraud
  • Abuse
  • Questionable billing practices

Still have questions?

  • You can find direct answers to your technical questions by visiting our Site Help page
  • Need to contact another Medicare department on this site? Go to our Site Contact page.
  • For help with technical problems using your computer on this website, email Palmetto GBA's Technical Assistance 

Feedback to the Centers for Medicare & Medicaid Services (CMS)
If you would like to send any feedback to CMS regarding your experiences with Palmetto GBA, please direct your comments to:

POE Coordinator
CMS Region IV
61 Forsyth Street, S.W., Suite 4T20
Atlanta, GA 30303-8909

 

last updated on 04/16/2012
ver 1.0.42