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CGS Administrators, LLC

Claim Denial Resolution Tool

This tool has been developed to provide the supplier community guidance on how to address claim denials in the most efficient manner. Enter the Reason Code and Remark Code (if applicable) from your Remittance Advice into the search fields below. The tool will provide the remittance message for the denial and the possible causes and resolution. Please Note: This tool is available for claim denial assistance with the common denials and may not address every scenario.

ANSI Reason Code (Do Not Include the Group Code):

(Required)

(Example:  16)

ANSI Remark Code (if multiple, include a comma and a space between each code):

(Optional)

(Example:  M81, M76)

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