Palmetto gba edi 2025

1. Click ‘Get Form’ to open the palmetto gba edi in the editor.
2. Begin by filling out the EDI Application Form. Ensure you include your Medicare Provider Number and National Provider Identifier (NPI) where requested.
3. Indicate the line of business and state for which you will be transmitting. Select all that apply to your request.
4. Complete the action requested section, choosing from options like 'Add Provider(s)', 'Change/Update Submitter Information', or 'Apply for New Submitter ID'.
5. Fill in your contact information, including phone number, email address, and mailing address. This will be used for communication regarding your application.
6. List each provider whose claims will be submitted by entering their Tax ID, email address, provider number, and NPI.
7. Once completed, retain a copy for your records and submit the form via fax or email to the appropriate jurisdiction's contact information provided in the document.

Start using our platform today to streamline your EDI enrollment process!