Please use the following form to enroll for Rail-Road Medicare:

**Rail-Road Medicare EDI Enrollment Application**

Submission Instructions: Once you have completed the form, please submit it via fax or email using the details below:

• Fax: 803-382-2416 (*Be sure to include area code 803 when dialing the fax number.*)
• Email: [RREDI.ENROLL@PalmettoGBA.com](mailto:RREDI.ENROLL@PalmettoGBA.com)

After submission, kindly notify us so we can enable the payer for you.

If you have any questions, feel free to reach out. We’re happy to assist!