DME MAC Jurisdiction C
CGS Administrators, LLC provides a variety of services for Medicare beneficiaries, health care
providers, and medical equipment suppliers in 33 states supporting the needs
of over 16 million Medicare beneficiaries nationwide.
As a Medicare Part A, Part B, Home Health and Hospice, and Durable Medical
Equipment contractor for the Centers for Medicare & Medicaid Services,
we process and pay Medicare claims according to the Congressional Laws and
CMS rules and regulations. We do not determine who is eligible for Medicare.
CGS Administrators, LLC currently provides Part A Medicare claims processing and customer support
services in the states of: Kentucky and Ohio. CGS also provides services
for Home Health and Hospice in the states of Colorado, Delaware, DC, Iowa,
Kansas, Maryland, Missouri, Montana, Nebraska, N Dakota, S Dakota, Pennsylvania,
Utah, Virginia, West Virginia, and Wyoming. In addition we provide services
for Medicare Part B for the states of: Ohio and Kentucky, and we provide
service to Durable Medical Equipment suppliers in the states of: Alabama,
Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico,
North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas,
U.S. Virgin Islands, Virginia, and West Virginia.
Claims Processing
This section has important information about filing claims to the DME MAC.
Most Medicare suppliers are required to bill claims electronically (rather
than paper) in accordance with the Administrative Simplification Compliance
Act (ASCA).
- Appeals
- Was your claim denied?
- Claims Submission
- How to submit a DME claim to CGS Administrators, LLC.
- Comprehensive Error Rate Testing
- The Centers for Medicare & Medicaid Services (CMS) developed the Comprehensive
Error Rate Testing (CERT) program to produce national, contractor-specific,
and service-specific paid claim error rates. Find CERT information and resources
here.
- Electronic Funds Transfer (EFT) Overview
- EFT allows payments to be received electronically by the provider of Medicare services. It is the required method of Medicare payment for all providers entering the Medicare program and for providers that are submitting a change to their existing enrollment information.Â
- Medicare Secondary Payer (MSP)
- Is another insurance involved with your claim?
- Modifier Finder Tool
- Are you a Medicare supplier who routinely uses modifiers in billing your
claims to Medicare?
- Online Claim Status Inquiry
- Claim Status Inquiry (CSI) is a dynamic tool that allows the supplier community to electronically check the status of production claims after they have passed the front-end edits.
- Overpayment Recovery
- Medicare payments received in excess of amounts due and payable under the
statute and regulations
- Reopenings
- How to correct a claim when you made a simple mistake.
Coverage & Pricing
- Fee Schedules
- The DMEPOS Fee Schedule and Drug Fees, Pharmacy Dispensing Fees and Pharmacy
Supply Fees
- Local Coverage Determinations (LCDs)
- Review active LCDs and Policy Articles, as well as draft articles and the
LCD Reconsideration Process.
- Medical Review
- What is Medical Review? What are the types of contractors we work with
to achieve the goal of reducing improper payments?
Education
- ACT (Ask the Contractor Teleconferences)
- This is your opportunity to ask questions regarding Medicare issues that
impact your company and receive answers from DME MAC Jurisdiction C subject
matter experts.
- CERT Task Force
- Learn more about the DME CERT Task Force, what they do, and scheduled events.
- Calendar of Events
- A listing of all Webinars, Workshops, and ACT calls available to you.
- POE Advisory Group
- CGS Administrators, LLC invites interested parties to participate in
our Jurisdiction C DME MAC Provider Outreach and Education (POE) Advisory
Group. The primary function of the Advisory Group is to assist us in the
creation, implementation, and review of provider education strategies and
efforts.
- Online Education Center
- Don't have time to attend a workshop or sit in on a Webinar? Our Online
Education Center allows you to choose from a variety of courses and to explore
them at your own pace.
- Video Education
- Our video education modules provide targeted information on a variety of
Medicare topics.
- Workshops and Seminars
- The CGS Administrators, LLC Provider Outreach and Education Team holds
a variety of workshops and seminars throughout Jurisdiction C. See if there's
one coming to your area.
- Webinars
- Webinars are live, one-hour, interactive conferences that you can view
online from the comfort of your own office. The audio portion of the Webinar
is handled just like a regular telephone call, giving the user the ability
to listen to the presentation and ask questions of the presenter.
- Talleres y Seminarios en Español - Spanish Language Workshops
and Seminars
- El Equipo de Alcance y Educación al Proveedor de CGS Administrators, LLC; ofrece una serie de Talleres y Seminarios en diferentes localidades de la Jurisdicción C. Entérese de cuando va a realizarse uno en su área.
- Spanish Language Webinars
- Webinars son en vivo, una hora de duración, conferencias interactivas
que se pueden ver en línea desde la comodidad de su propia oficina.
La parte de audio del Webinar se maneja igual que una llamada telefónica
normal, dando al usuario la capacidad de escuchar a la presentación
y preguntas del presentador.
- HEAT Provider Compliance Training
- CGS Administrators,
LLC on Facebook
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FAQs
- CMS FAQs
- By selecting this option, you will be taken to the CMS website.
- Current FAQs
- Choose from a variety of topics, including Oxygen, Medical Review, Claim
Submission, Power Mobility Devices, and more.
- Archived FAQs
- A complete listing of past FAQs on a variety of topics, including Oxygen,
Claim Submission, Medical Review and more.
CGS Administrators, LLCNews & Publications
- Supplier Manual
- The Supplier Manual is updated on a quarterly basis. If you have billed
a claim to Jurisdiction C in the past 12 months, then you will automatically
receive a CD-ROM containing our quarterly Supplier Manual updates, as well
as the most recent issue of our quarterly newsletter, the DME MAC Insider.
- News
- Important and timely articles and information for the current month.
- News Archive
- Past articles and information from 2007 to present.
- DME MAC Insider
- The DME MAC Jurisdiction C Insider contains important information that
will assist the supplier community in day to day operations. It includes
information published during the previous quarter by the Centers of Medicare
and Medicaid Services (CMS) and by CGS Administrators, LLC.
- Medicare Advisory Archive
- These publications were released from March 1993 to Spring 2007 by Palmetto
GBA. Please note that the supplier is responsible for accessing the most
recent information available.
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