Skip to Main Content

Print | Bookmark | Email | Font Size: + |

February 9, 2022

Reminder About Beneficiary Addresses

CGS wants to remind suppliers that the address listed on a claim needs to match the beneficiary’s current address on file with the Social Security Administration (SSA). Claims are determined based on the beneficiary's address at the time the claim is processed, not the beneficiary's address on the date of service.

For example:

  • A beneficiary lives in Illinois on the date a manual wheelchair is delivered.
  • The supplier begins billing for monthly rentals for the wheelchair.
  • Four months later, the beneficiary moves to Florida and updates their address with SSA.

In this case, the claims for the remaining months of rental must list the beneficiary’s Florida (current) address on file with the SSA at the time the claim is submitted.

Claims denied with the following American National Standards Institute (ANSI) codes must be resubmitted to the correct jurisdiction with the beneficiary’s current address:

CO-109: Claim/service not covered by this payee/contractor
Remark code N104: This claim/service is not payable under our claims jurisdiction area

For more information, read DME MAC Jurisdiction C Supplier Manual Chapter 6PDF.

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved