====== Palmetto Medicare Enrollment ======

Follow the instructions on the form to submit it to **Palmetto GBA**.  
After submission, please send a copy to **ClaimRev** at [[mailto:support@claimrev.com|support@claimrev.com]].

{{ :palmeto_gba_edi_enroll_b_ga.pdf | **Palmetto GBA Part B Enrollment Form**}}