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November 6, 2023

New Authentication Requirement When Calling the Provider Contact Center – Revised

To protect the privacy of Medicare beneficiaries and providers, CGS is required to authenticate certain elements before releasing beneficiary-specific information. Our Computer Telephone Integration (CTI) systemPDF allows you to securely enter beneficiary information before speaking to a Customer Service Representative (CSR).

Beginning March 1, 2024, claim- and eligibility-specific calls to the Provider Contact Center (PCC) must be authenticated through the CTI line. CSRs will no longer authenticate information verbally over the phone. We will transfer callers back to the CTI line for authentication.

You must authenticate the following elements using our Computer Telephone Integration (CTI) systemPDF:

  • Provider National Provider Identifier (NPI)
  • Provider Transaction Access Number (PTAN)
  • The last five digits of the provider Tax Identification Number (TIN)
  • Medicare Beneficiary Identifier (MBI)
  • Beneficiary's first initial
  • Beneficiary's last name – Enter up to six letters followed “#” sign (ignore any spaces)
  • The beneficiary's date of birth.

We do not require authentication for general questions.

NOTE: The Interactive Voice Response (IVR) system and the myCGS Web Portal can answer most questions about a beneficiary's Medicare eligibility and claim status. CSRs will transfer callers to the IVR for these types of questions.

Here are examples of Claim Specific and General questions:

Claim Specific Question General Question
  • Medicare eligibility information
  • Claim information (pending/processed)
  • Same or similar claim information
  • How to read a remittance advice
  • How to find information on the CGS or the CMS website
  • Questions about coverage (not related to a specific beneficiary)
  • Requesting a mailing address or telephone number

Publication History

November 6, 2023 Originally Published
February 1, 2024 Effective date changed from February 1, 2024, to March 1, 2024


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