November 5, 2024 – Updated: 01.14.2025
IVR Beneficiary Eligibility
To protect beneficiaries from Medicare fraud, Medicare Administrative Contractors (MACs) must disable beneficiary eligibility information from their Interactive Voice Response (IVR) systems by March 31, 2025.
CGS will disable IVR beneficiary eligibility information on February 28, 2025, at 5 pm CT (6 pm ET).
You must check your patient's eligibility using:
- myCGS portal
- Billing agencies, clearinghouses or software vendors
- HIPAA Eligibility Transaction System (HETS)
- Direct Data Entry inquiry option 10 (Part A & HHH providers)
- Professional Provider Telecommunications Network (Part B providers)
As a reminder, Customer Service can't provide eligibility information and must refer callers to one of these systems.
See the Checking Medicare Eligibility fact sheet or CMS instruction for more information.