EDI Online Application

JM Part A EDI Enrollment

Welcome to EDI Online Enrollment

Palmetto GBA now offers Electronic Data Interchange (EDI) online enrollment.

Please select the appropriate options to access the forms needed to submit your request. The EDI Enrollment: Finding Forms Online tool is helpful if you are not sure which options to select. You will receive a tracking number once you click on Submit. Once the forms have been processed, an email which includes the status will be sent to the Submitter and Provider email addresses entered on the forms.

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