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Claim Documentation Divider Sheets

CGS has created the Divider Sheets Tool to assist you in submitting the different types of documentation needed to support your claim. Simply select the type of documentation you are submitting from our list of items below. Then print the pre-designed divider sheet and place it in front of the document(s) that will be submitted for review.

As a reminder: Medical records and documents should never be altered by hi-lighting, circling or otherwise marking to bring attention to information on the record. It is not necessary to use an additional cover sheet or number the documents. Sending more than what is needed could slow down the review process and delay processing of your claim.

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Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.


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