January 21, 2016
GOOD NEWS! Medical Review Decision Letters Available through myCGS!
myCGS, our secure online web portal, allows CGS J15 providers to perform a number of functions securely over the web. It was recently enhanced to allow you immediate access to your Part A and Part B medical review decision letters!
Currently, decision letters are available for physical therapy services submitted by Part B providers credential as Family Practice (specialty 08); and Part A claims for major joint procedures. Additional specialties/services will be added over the coming months!
Once a decision is made on a claim for which documentation was requested and submitted, notification will be sent to your secure myCGS inbox located under the MESSAGES tab.
Select the message. A new window will display informing you a letter from our medical review department is available. Click the link in the message to view the actual decision letter.
The decision letter will identify the National Provider Identifier (NPI) and details of the claim including the patient's Health Insurance Claim (HIC) number, name, and information on each line item of the claim.
NOTE: Decision letters are saved as a Portable Document Format (PDF) file. Once the decision letter is displayed, you may print the letter by selecting the "print" icon in the menu of your Acrobat Reader software. If you do not have Acrobat Reader software, a download is available at no cost.
For information on other myCGS functions, including responding to additional documentation requests received from our medical review department, please refer to the myCGS User Manual.