Corporate
CGS Administrators, LLC

Supplier Interactive Voice Response (IVR) System

CGS DME MAC Jurisdiction C has an Interactive Voice Response (IVR) System at 866.238.9650 with multiple options to assist you. The IVR is available 24 hours a day, 7 days a week with the exception of system upgrades or routine maintenance. The IVR menu options that require system access are available Monday - Friday 6:00 AM - 8:00 PM and Saturday 6:00 AM - 4:00 PM Central Time (please note that some options which access the Common Working Files may have shorter availability).

The IVR offers information regarding claim status, pending claims, Redetermination status, beneficiary eligibility, Certificate of Medical Necessity (CMN) status for same or similar equipment inquiries, SNF/Inpatient hospital stay information, hospice information, diabetic supply claims, diabetic shoe claims, pricing, outstanding checks, the last 5 checks issued, offsets and EFT application status. It also offers some general information, such as customer service hours of operation. Our customer service representatives are available at 866.270.4909 Monday - Friday from 7:00 AM - 5:00 PM Central Time, for inquiries that cannot be handled through the IVR.

For an abbreviated/quick reference version of the information below, refer to our IVR Flow ChartPDF.

Current features of the IVR:

Option 1 - Claim Information

Press 1 - Claim Status Inquiry (pending, on the payment floor, denied, paid and/or applied to deductible)

Press 2 - Pending claim Information

Press 3 - Redetermination Information

Press 4 - To order a duplicate remittance notice

Press 5 - Ordering/Referring Provider Information

Option 2 - Beneficiary Information

Press 1 - Beneficiary Medicare Eligibility Information

Press 1 - SNF/Inpatient Hospital Stay

Press 2 - Hospice Information

Press 2 - CMN Status

Press 3 - Oxygen CMN Status

Press 4 - Diabetic Supplies and Diabetic Shoes Information

Option 3 - Payment Information

Press 1 - Pricing

Press 2 - Check information

Press 3 - Offset information

Press 4 - EFT Application Status (pending, approved, rejected and the reason why it is rejected.)

Option 4 General information

Press 1 - Information on your Appeal Rights

Press 2 - Customer Service hours of operation

There is no limit to the number of claims you can check in the IVR!!

Below are some quick tips on accessing information through the IVR:

To enter a Provider Transaction Access Number (PTAN), formerly known as your supplier number:

If the PTAN contains a letter, press 1. Enter the PTAN excluding the C followed by the "#" key.

If the PTAN does not contain a letter, press 2. Enter the 10-digit number followed by the "#" key.

The IVR will repeat the number entered. Press 1 if the number entered is correct. If you would like to reenter the number, press 2.

To enter a beneficiary's Medicare number:

Press 1 for the MBI

To enter a MBI:

Press * to indicate you are entering a letter.

To enter a letter, you will need to press 2 keys.

  1. Press the key that contains the letter on your telephone key pad.
  2. Press 1, 2 or 3 to indicate the position of the letter on the telephone key pad (i.e., to enter the letter A – press 2 1).
    1. Assume letters Q and Z are located on the 1 key pad. Q is the first position and Z is the second position (i.e., to enter the letter Z press 1 2).

Press 2 for the HICN

If the Medicare number begins with a letter, press 1. Then,

If it is any other letter(s) press 9

Enter the 6 or 9 numbers following the prefix followed by the # key.

If the Medicare number begins with a number, press 2. Then,

Enter the nine-digit Medicare number.

The system will then prompt you to enter the alpha character at the end of the Medicare number.

To enter a date of service, use MM/DD/YY format (e.g., 010107).

To enter a FCN number:
Enter the FCN number including any sequence number followed by the "#" key. Exclude first two zeros of FCN located on an overpayment letter.

To enter the beneficiary's first initial
Enter the beneficiary's first initial by using the letters on your telephone keypad (i.e., for A enter 2).

To enter the beneficiary's last name:
Enter the first six letters of the beneficiary's last name by using the letters on your telephone keypad followed by the # key (i.e., for Smith enter 76484#). Include any suffixes, such as 'Jr.' or 'III' if included in first 6 letters (i.e., for Smith Jr. enter 764845#). Exclude any special characters, such as 'hyphen' or 'apostrophe'.

The corresponding letters of the telephone keypad numbers are:

Claim Information (Option 1)

For claim Status, press 1 - To receive claim status you must enter your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number and name and the date of service. (See instructions above on entering this information.) After getting the status of a claim, you may choose from the following:

For Pending Claim Information, press 2 - You will need to enter your NPI and PTAN and last five digits of tax identification number (TIN).

Press 1 and the total amount of claims, the total submitted amount and the total expected payment amount for the claims currently on the payment floor will be provided.

Press 2 and the total amount of claims and the total submitted amount for the claims pending at the Common Working File (CWF) will be provided.

Press 3 and the total amount of claims and the total submitted amount for other pending claims will be provided.

For Redetermination information, press 3 - To verify redetermination information you must provide your NPI, PTAN, and the last five digits of your tax identification number (TIN).

To receive redetermination status, you must provide the beneficiary's Medicare number, the beneficiary's name, and the DCN from your acknowledgement letter or claim number (CCN, ICN) of the claim that is being appealed. The IVR will provide the status of your redetermination request, including whether it is pending, reversed, partially reversed, upheld, or dismissed. You may also request a copy of the redetermination decision letter.

For a duplicate Remittance Notice, press 4 - You will need your NPI, PTAN, last five digits of tax identification number (TIN), and the payment report date. (See instructions above on entering this information.) You will receive a duplicate remittance notice in the mail.

For Ordering/Referring provider information, press 5 - You will need your NPI, PTAN and last five digits of tax identification number (TIN) and the NPI and last name of the ordering/referring provider. This option will verify if the ordering/referring provider is currently enrolled in PECOS.

Beneficiary Information (Option 2)

For eligibility information, press 1 - To verify Medicare eligibility for a beneficiary you must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, date of birth and the beneficiary's name. This option will provide the Medicare Part A and B entitlement date and term date, the current and previous year deductible remaining, Medicare Advantage Plan information, home health episode information and Medicare secondary payer information.

Press 1 to receive SNF/ Inpatient hospital information for the same beneficiary. If a facility claim is on file for the date of service entered, the IVR will provide the NPI of the facility and the website address for NPPES if the beneficiary was still inpatient, the admission date, and the type and date of discharge if the beneficiary was discharged.

Press 2 to receive hospice information for the same beneficiary. The IVR will provide the start and end date of the most current Hospice episode on file.

You may press 1 or 2 at any time after the beneficiary information is entered.

For CMN status, press 2 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, the beneficiary's name and date of birth, and the procedure code. This option will provide CMN information on file for the procedure code entered and also CMN information on any similar equipment on file for a beneficiary. The IVR will provide the initial, recert or revision date, the length of need, the previous supplier's phone number, the last rental date billed and the total months paid for rented items. If there is more than one same or similar CMN on file for the procedure code entered, the IVR will prompt you to listen to all related CMNs.

For Oxygen CMN status, press 3 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, the beneficiary's name and date of birth. This option will provide the most current oxygen CMN information on file by modality (stationary or portable). The IVR will provide the initial, recert or revision date, the length of need, the previous supplier's phone number, the last paid date with modifier and the total number of paid claims per modality. If there is more than one same or similar CMN on file for the modality chosen, the IVR will prompt you to listen to all related CMNs.

Press 1 to receive stationary oxygen information.

Press 2 to receive portable oxygen information.

For diabetic supplies and diabetic shoes information, press 4 – You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, the beneficiary's name and date of birth. If you select 1 for diabetic supplies, this option will provide claims on file for lancets and test strips billed within 90 days before and after the date of service entered. The IVR will return the procedure code billed, the date of service, the number of services, the NPI of the billing supplier and state if the service was not approved for payment. You may also opt to check claims for other diabetic supplies.  You may enter the last four digits of the procedure code and the IVR will check for claims for that code billed within 6 months before and after the date of service entered.

If you select 2 for diabetic shoes, this option will check for diabetic shoe claims billed within the calendar year entered. The IVR will return the procedure code billed, the date of service billed, the number of services, the NPI of the billing supplier and state if the service was not approved for payment. You may also opt to check claims for diabetic shoe inserts.  You may enter the last four digits of the procedure code and the IVR will check for claims for that code billed within the calendar year entered.

Payment Information (Option 3)

For the Medicare allowed amount on a specific procedure code, press 1 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), specify the state where the beneficiary resides, and the HCPCS code and modifiers. The current Medicare allowed amount would be provided.

To enter letters for a state code:

To enter the HCPCS code you're looking for.

Enter the next 4 digits of the procedure code.

If there is a modifier at the end of the procedure code, press 1, otherwise press 2.

If the procedure code is followed by a modifier:

For check information, press 2 - You will need to enter your NPI, PTAN, and the last five digits of your tax identification number (TIN).

Press 1 for the outstanding checks on file for the last month including the check date and check amount.

Press 2 for the last 5 checks issued to the PTAN entered. This includes the check date and check amount.

For offset information, press 3 - You will need to enter your NPI, PTAN, the last five digits of your tax identification number (TIN), and the FCN number located on your Medicare remittance notice. You will have the option to receive claim detail information on the original overpayment and/or the original overpayment letter date and current offset balance amount. The claim detail information includes the beneficiary's Medicare number, overpayment amount and dates of service for each claim involved in the original overpayment. Claim detail information is available for FCNs that contain 34 claims or less. If the FCN contains more than 34 claims, you may request a copy of the original overpayment letter by faxing your request to 615.782.4623.

For EFT application status, press 4 - You will need to enter your NPI, PTAN, and the last five digits of your tax identification number (TIN). This option will provide the status of your EFT application including whether it is pending, approved, rejected and the reason why it is rejected.

General Information (Option 4)

For information about your appeal rights, press 1 - Information about what services are eligible for a review, the elements that should be included in a review request and the proper party to a review is provided.

For customer service hours of operation, press 2 - The IVR provides the hours of operation and telephone number of the customer service line.

To repeat these choices, press 7

To return to the main menu, press 8

To get information about another NPI/PTAN, press 9

Related Information

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