eServices Financial eForms: eCheck and eOffset

eServices users can submit immediate offset requests and electronic payments for Medicare overpayments and voluntary refunds in eServices using Financial eForms.

eCheck - This eForm allows payments to be sent electronically to Palmetto GBA securely through our eServices portal. Only check payments are accepted through this form. There is no transaction fee for submitting a check payment.

eOffset - This eForm allows offset information to be sent electronically to Palmetto GBA.  You have the option to request an immediate offset when you receive a demanded overpayment or make a permanent request for all future demanded overpayments.

These eForms are dynamic and contain edits to ensure that the information needed to process the overpayment is entered. Submitting the forms through eServices automatically enters your information into Palmetto GBA's workflow management system, iFlow, for processing according to current Medicare guidelines. You will receive a message in eServices when the form is submitted and another message in eServices with the Document Control Number (DCN) when the form has started processing.  You can use the DCN to look up form processing status and view your submitted forms in eServices.

More information about these eForms can be found in the Financial Tools, and Secure Messaging and Forms sections of our eServices User Manual (PDF, 7.78 MB).

Not an eServices user yet? Sign up today to take advantage of online form submissions and the other time saving eServices features including online eligibility and claim status, online remittances, and eClaim submissions.

You can participate in eServices if you have a signed electronic data interchange (EDI) Enrollment Agreement on file with Palmetto GBA. If you are already submitting claims electronically, you do not have to submit a new EDI Enrollment Agreement. See the eServices portal for more information. 

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Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

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