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Provider 360 Program


Provider 360 Program

Overview

Continuous Improvement is best thought of as a business culture or approach which involves everyone – leadership, management, and employees – in finding and eliminating waste on an ongoing basis. CGS's Provider 360 (P360) program helps providers and suppliers reduce or eliminate claim denials and errors by way of Lean education. Lean is a systematic approach to reduce or eliminate activities that do not add value to the process. CGS offers personalized Lean education by invitation only. If you have questions about this program, email us at CGS.PROVIDER360@cgsadmin.com.

Review the CGS P360 Information GuidePDF for more information about Lean.

Personalized Lean Education

This free education includes three informative sessions:

  • Session 1 goes over Lean process improvement tools (i.e., Root Cause Analysis, Quality Assurance Standards) that will help your organization find issues that may cause claim denials and errors. After attending the session, your organization will be equipped with the knowledge necessary to build a Value Stream Process Map (VSM) and find Opportunities for Improvement (OFIs) through Root Cause Analysis (RCA). A CGS Continuous Improvement Coach leads this personalized session.
  • During session 2 we will review your specific claim errors and denials.
  • Session 3 is the final follow up session where we will review your OFIs from your VSM map.
Three Sessions (4.5 Hours) 

Three Sessions (4.5 Hours)

To see the details for each session, click on the title below, review the CGS P360 Personalized Lean Education FAQPDF, and watch the CGS P360 Introduction Video. The video provides an overview of the program.

Lean Education: Session 1 (1.5 hrs.)

Personalized Education: Session 2 (1.5 hrs.)

Follow Up: Session 3 (1.5 hrs.)


Supplier Comments

Supplier Comments

"The sessions gave insight on specific expectations, helping identify areas of improvement, provide resources beneficial to improvement and overall guidance."

"Everyone on the call makes you feel welcome and really do want to see you succeed."


P360 Resources

P360 Resources

CGS P360 Personalized Lean Education FAQPDF

CGS P360 Standard Documentation Requirements ChecklistPDF

CGS P360 Introduction Video

Three Sessions (4.5 Hours) 

General Education


CMS Comprehensive Error Rate Testing (CERT)External website

CMS CERT ReportsExternal website

CMS CERT C3HUBExternal website

CERT Task Force

CMS Medicare Coverage Determination ProcessExternal website

Local Coverage Determinations (LCDs)

CMS Internet Only Manuals (IOMs)External website

Medical Review Resources

Additional Documentation Request (ADR) Process

Provider Outreach and Education Resources

Updated: 04.23.2025

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