Palmetto GBA provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.palmettogba.com |
|---|---|
| Payer contact reference | 1-855-696-0705 |
| Claims payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| Eligibility payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Palmetto GBA. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| Timely filing | 365 days (verify applicability) |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- This registry has not established a payer-specific appeal ladder for Palmetto GBA. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
- This registry has not established one national ERA payer ID for Palmetto GBA. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment.
Palmetto GBA at a glance
| Legal name | Palmetto GBA, LLC |
|---|---|
| Also known as | Palmetto, Palmetto Medicare |
| Category | Government program |
| Parent organization | BlueCross BlueShield of South Carolina |
| Claims payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| Eligibility (270/271) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Palmetto GBA. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| NAIC company code | Not established in this registry |
| States covered | Nationwide (50 states) |
| Provider resource entry point | https://www.palmettogba.com |
| Provider phone | 1-855-696-0705 |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Palmetto GBA
This registry lists 365 days as an initial-claim reference for Palmetto GBA. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
| Submission type | Window |
|---|---|
| Initial claim reference | 365 days (verify applicability) |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Palmetto GBA. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Palmetto GBA provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Palmetto GBA
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Palmetto GBA electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Palmetto GBA. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Palmetto GBA
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Palmetto GBA volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 270 / 271 eligibility | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Palmetto GBA. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Medicare coverage policies from Palmetto GBA
Palmetto GBA maintains 189 active Local Coverage Determinations across 15 Medicare contracts in the current Medicare Coverage Database export. Each LCD applies only to claims this contractor processes, so the same service can be covered under different criteria by the contractor next door. It also serves as a home health and hospice MAC for some states.
Selected active policies from this contractor
A selection, not the full list: policies with measured search demand come first, then those on topics that more contractors publish LCDs for.
- L35025 MolDX: Molecular Diagnostic Tests (MDT)
- L37379 Echocardiography
- L39671 Trigger Point Injections (TPI)
- L34415 CT of the Abdomen and Pelvis
- L39853 Outpatient Psychotherapy
- L35724 Urine Drug Testing
States where it is the A/B MAC
Evaluate QuickIntell workflow fit for Palmetto GBA
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Palmetto GBA; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Palmetto GBA; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Palmetto GBA before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
- QuickCode
Evaluate documentation and coding-review controls for Palmetto GBA; require applicable sources and qualified review rather than assuming payer-specific edits are configured.
Frequently asked questions about Palmetto GBA
Where is the Palmetto GBA provider portal?
Use https://www.palmettogba.com as a starting point for Palmetto GBA provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Palmetto GBA?
This registry lists 365 days as an initial-claim reference for Palmetto GBA. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
Does Palmetto GBA publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Palmetto GBA. See the source findings for transaction-specific references. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Palmetto GBA accept electronic claims?
Verify Palmetto GBA electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Palmetto GBA denial?
This registry has not established a payer-specific appeal ladder for Palmetto GBA. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Palmetto GBA prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Palmetto GBA provider phone number?
This registry lists 1-855-696-0705 as a contact reference for Palmetto GBA. Confirm the number and service scope against the member ID card and current product-specific directory; claims, eligibility and authorization inquiries may use different teams.
Automate workflows around Palmetto GBA requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Palmetto GBA's current published documents before submission. CPT® is a registered trademark of the American Medical Association.