Medicare

How to Get Credentialed with Palmetto GBA (Jurisdiction J/M) in Virginia

Network: Open
60-90 Days

Quick Overview

Timeline

60 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Virginia-Specific Requirements

Palmetto GBA (MAC Jurisdiction J/M) processes all Medicare Part A/B claims for Virginia. Enrollment is through PECOS using CMS-855I (individual) or CMS-855B (group). Virginia has a diverse provider landscape, from the densely populated Northern Virginia area (near DC) to rural Appalachian communities. Providers near DC who also practice in the District should be aware that DC is under a different MAC (Novitas/JH). CMS standard screening applies. A valid NPI is required, and revalidation occurs every 5 years. Initial enrollment takes 60–90 days.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Virginia.

2

Prepare Your Application

Complete Palmetto GBA (Jurisdiction J/M)'s provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Palmetto GBA (Jurisdiction J/M).

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

CV/Resume

DEA License

Conditional

Required if applicable

Malpractice Insurance

Medical License

NPI Certificate

Contact Information

Claims Inquiry

National

1-855-696-0705

Medicare Enrollment

National

Medicare Appeals

National

1-855-696-0705

Quick Links

Palmetto GBA (Jurisdiction J/M) Website Provider Portal

Need Help?

Let PayerReady handle your Palmetto GBA (Jurisdiction J/M) enrollment in Virginia.

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Palmetto GBA (Jurisdiction J/M) in Other States

Alabama Georgia North Carolina South Carolina Tennessee

Other Payers in Virginia

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Kaiser Permanente CareFirst BlueCross BlueShield Anthem Blue Cross and Blue Shield of Virginia
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