About the Customer Service Department
When calling Customer Service, you will initially speak to a Tier 1 CSR. Tier 1 CSRs are capable of handling most supplier inquiries. In some cases, Tier 1 CSRs may need to transfer the call to a Tier 2 CSR (also known as the Help Desk). If a callback is required, a Tier 2 CSR will return your call within 10 business days.
If you have a complex inquiry that goes above and beyond the normal scope of a Tier 1 or Tier 2 CSR, the inquiry will be forwarded to the third level of Customer Service, the Provider Relations Research Specialist (PRRS) team. The PRRS will research the inquiry and respond either by phone or by mail within 45 business days.
Customer Service Representatives are able to:
- Clarify the denial reason associated with a claim
- Provide general information regarding Medicare coverage
- Explain terminology and information published in issues of the DME MAC Insider and the Supplier Manual
- Assist with other complex issues
Customer Service Representatives are not able to:
- Provide claim status, beneficiary eligibility, or other information which is available through the IVR
- Give preauthorization of beneficiary entitlement for specific DME
- Adjust a claim, unless the claim was processed incorrectly by the contractor (please call Telephone Reopenings at 866.813.7878)
- Answer questions about supplier enrollment (please call the National Supplier Clearinghouse at 866.238.9652)
- Answer questions about electronic billing software or claims that have not been received in our claim processing system (please call CEDI at 866.311.9184)
- Answer inquiries from beneficiaries or their representatives (please call 1.800.MEDICARE – 800.633.4227)
Medicare beneficiaries and their representatives should contact 1.800.MEDICARE (1.800.633.4227) for all of their questions about Medicare. 1.800.MEDICARE is available to assist beneficiaries 24 hours a day, 7 days a week. For questions specific to DME MAC, beneficiaries should ask for "Medical Supplies" or visit the Medicare.gov
website.
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