Jurisdiction M Part B providers will need the following information to enroll in Electronic Data Interchange (EDI): Provider Transaction Access Number (PTAN), National Provider Identifier (NPI), and demographic information for the location.
- If you only want access to Palmetto GBA’s eServices portal, please fill out an EDI Enrollment Agreement (PDF).
- If you will be submitting directly to Palmetto GBA and not using a clearinghouse, please complete the Direct Submitter forms (PDF). You will need to select a Network Service Vendor (PDF) or an Network Service Vendor (PDF) if you have not already chosen one.
- If you are using a Billing Service or a Clearinghouse to submit your claims, please complete the Billing Service-Clearinghouse forms (PDF) once you have discussed what EDI services they will be providing for you.
Palmetto GBA EDI has created an overview of the JM Part B EDI Enrollment process (PDF) outlining EDI options available to all submitters.