Corporate

Self-Service Options

The following tools are designed for home health and hospice providers who submit claims to CGS.

Tool Description

277CA Edit Lookup Tool

Allows Trading Partners, billing services, providers, and clearinghouses to view easy-to-understand descriptions associated with the edit code(s) returned on the 277CA – Claim Acknowledgement for 5010A1 claims.

NEW! Additional Development Request Timeliness Calculator

Additional Development Request (ADR) documentation must be received by CGS on/before 45 calendar days of the request for review and payment determination. The ADR timeliness calculator will assist you in determining the date ADR documentation must be received in order to meet the time frame for submission.

NEW! Appeals Decision Tree

Follow this decision tree to determine if you need to request a reopening or a redetermination.

Appeals Timeliness Calculator

Determine the date your appeal request must be received in order to meet the timeliness guideline.

NEW! Average Provider Enrollment Applications Processing Time

CGS Provider Enrollment now provides average enrollment application processing times so you will know how long it takes to complete the enrollment process. Use this tool to access details and average processing times for your application.

CERT Claim Identifier Tool

Determine the outcome of a CERT reviewed claim, and the reviewer's comments for a claim denied by CERT. Simply enter the Claim Identifier (CID) number assigned to the claim by CERT.

CGS GO Mobile App

CGS is keeping you connected with our free CGS GO Mobile app! Now, you can access contact information, CGS monthly Bulletins, MLN Connects, physician fee schedule information, and read LCDs, related policy articles and more! Download today!

CGS Provider Enrollment Application Status

Enter the Reference Number from your acknowledgment letter and the 5-digit Zip code of the contact address to check the status of your enrollment application.

EDI Report Request Tool

Allows providers to request a claim response report, or an electronic remittance advice.

Home Health 60-Day Episode Calendar SchedulePDF

Assists home health providers in determining the 60th day from the start of care (SOC) date.

Home Health 60-Day Episode: 2016 Calendar Schedule PDF

Assists home health providers in determining the 60th day from the start of care (SOC) date for the 2016 calendar.

Interactive Voice Response (IVR) System

Access the home health and hospice IVR system at 1.877.220.6289 for claim and redetermination status, beneficiary eligibility, financial, and general information.  The IVR is available 24/7.  Refer to the IVR User Guide for additional information.

Hospice Payment Rates Calculator

Calculates the standardized Medicare payment amount for each hospice level of care.

Interactive Medicare Electronic Remittance Advice (ERA)

This interactive guide provides an overview of the ERA using PC-Print. Select the screen option (below) that you wish to view. As you move your mouse over the area of interest, the field(s) will highlight. Click on the area of interest to view more detailed information.

Interactive Medicare Standard Paper Remittance (SPR) Advice

This interactive guide provides an overview of the SPR Advice. Select the section (below) that you wish to view. As you move your mouse over the area of interest, the field(s) will highlight and the name of the field will display. Click on the field to view more detailed information.

New! IVR and CTI Converter Tools

The Interactive Voice Response (IVR) and Computer Telephone Integration (CTI) systems require entry of your patient's name and Medicare number during the beneficiary validation process.  This tool:

  • Converts the beneficiary's first initial of their first name and first six letters of their last name to the numbers necessary to enter on your telephone keypad.
  • Converts the 11 digit alpha/numeric Medicare Beneficiary Identifier (MBI) to the numbers/characters necessary to enter on your telephone keypad.

Medicare Deductible / Coinsurance Look-Up

Medicare beneficiaries who receive covered Part A services may be subject to deductible and coinsurance.  Covered Part B services are subject to an annual deductible and coinsurance.  Select the year from the drop down menu to access deductible and coinsurance amounts for that Calendar Year.

Medicare Secondary Payer (MSP) Online Tool

Decision tree that provides complete billing information based on the type of MSP record.

myCGS

myCGS is a web-based application developed specifically to serve the needs of health care providers and their staff.  Access to myCGS is available 24/7, and is free of charge. 

myCGS Comparative Billing Reports (CBR) for Home Health and Hospice Providers

The purpose of the Comparative Billing Report (CBR) is to show provider specific billing pattern data in comparison to peer groups within your state and the CGS jurisdiction. This information is helpful in conducting education and self-audit activity. Refer to the CBR Job Aid PDF for additional information.

Provider Enrollment Interactive Help Tool

This interactive tool is designed to walk you through the application process simply by asking you a series of questions.  Feel confident that you are selecting the correct CMS-855 application, completing the sections applicable to your situation, including the supporting documentation, and accessing other forms needed to complete your enrollment.

Updated: 04.03.18


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