Switching to Palmetto GBA
Switching from NHIC to Palmetto GBA Jurisdiction 1
On April 11 of this year all providers in California and Nevada who submited electronic claims to NHIC received a letter from Palmetto GBA. This letter contained directions on switching from NHIC to Palmetto GBA.
It has come to our attention that many offices did not follow-up on the directions and are not ready for the change. What follows are the steps you should take to get enrolled and what changes you need to make to your VersaForm program and the HyperTerminal program to successfully send claims to Palmetto GBA.
Obtain a New Submitter ID
- If you are reading this on our website, just click on this link: J1_EDI_Application_Form.pdf (318 KB).
- Otherwise
- This will open a PDF file – print this file. The first pages are instructions. On Page 4 fill in the form.
- You don’t have a submitter ID yet, leave it blank.
- Leave the PPTN ID, DDE ID and PS&R ID blank.
- Fill in the Submitter Name, it is the name of the person or entity submitting the file.
- Fill in everything from Contact Person down to E-mail Address.
- Put Xs in all of the GPNet Asynchronous boxes.
- Fill in VersaForm Systems Corp as the Software Vendor.
- Fill in 1147JB as our Vendor Security ID.
- Fill in your first, or only, Provider Name, and his or her Medicare ID and personal NPI.
- Put Xs in No, Submit Claims, Receive Reports and Receive Electronic Remittances.
- If you have more than one Provider to be sent by your office (the submitter of the file), fill them in on the last page.
Click here for the full-sized image.
Click here for the full-sized image.
We were approved by NHIC and so we are approved by Palmetto GBA.
The EDI Assistance number for Palmetto is: 866-749-4301 and is available Monday – Friday from 8:00 am to 5:00 pm.
You can look up the status of your enrollment application at http://www.palmettogba.com/palmetto/IVR.nsf/IVR_Display?openform. You may have to wait a while for the site to come up.
How to Change VersaForm for Sending to Palmetto GBA
In VersaForm:
- Click on Setup and then the Claims Processors Tab.
- Edit your current Medicare Claims Processor.
- You may change the Name or not, as you wish.
- Change the Receiver ID and Application Receiver Code to 01102 for Northern California, 01192 for Southern California and 01302 for Nevada.
- Change the Qualifiers to HCFA Carrier Identification Number.
- Nothing else needs to be changed.
- Click on OK
- Now click on the Insurance Plans Tab.
- Find and edit your Medicare Insurance Plan to make these modifications:
- Change the Payer ID and Destination Payer Receiver Code to 01102 for Northern California, 01192 for Southern California and 01302 for Nevada.
- Click OK.
Click here for the full-sized image.
Click here for the full-sized image.
Modify HyperTerminal for Sending Claims
- Start the Medicare link on your desk top as you normally do.
- When you see:
- Click OK
- When you see:
- Click Modify
- Change the Area code to 803.
- Change the Phone number to 788-9860. The window will look like this:
- Click OK.
- Dial as you do normally.
When Palmetto's computer answers, the initial screen will be different, but the login and passwords work the same as in the past. The Send and Receive icons will point to the same folder you have always used.
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