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myCGS Part B Automated Reopenings: Non-MSP (Other Situations)

Part B providers may submit Reopening requests to make simple corrections to non-MSP claims for situations not addressed with any of the other options.

NOTE: Reopening requests must be submitted within 12 months of the original claim remittance date.

Automated Reopenings Request Form Instructions: Non-MSP (Other Situations)

  1. Once you are logged into myCGS, select the FORMS tab.

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  2. From the Secure Forms page, select REOPENINGS from the Select a Topic drop-down box.

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  3. The Select a Type drop-down will default to REOPENINGS.  Click on the “Reopenings: ER-J15-B-1010” link located at the bottom of the page.

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    The Reopening Request form will display.  Required fields are identified by a RED asterisk (*).  For your convenience, some fields of the form are pre-populated with information specific to your myCGS User ID and PTAN/NPI combination.
  4. Verify/complete the PROVIDER INFORMATION section.
    • Add your phone number in the appropriate field.
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  5. Complete the BENEFICIARY INFORMATION section.
    • Enter the patient’s name
    • Enter the patient’s Medicare ID.
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  6. Complete the CLAIMS INFORMATION section.
    • Enter the Claim Internal Control Number (ICN). The ICN is located on your CGS RA.
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    • Click the drop-down box under Type and select NON-MSP – OTHER SITUATIONS.
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    • The Action, Line, and Position drop-downs, in addition to the New Value field are not applicable when this type is selected, so they will be grayed.
    • In the Reason for Request field, please provide details about your request.  For example:
      • If you received a timely filing denial, explain why the claim should be adjusted.
      • Did you receive an incorrect denial for global surgery?  Provide details here.
      • Was an Advance Beneficiary Notice of Non-Coverage (ABN) signed? Add this information here and attach a copy of the signed ABN.
      • Was there a duplicate or a clearinghouse issue?  State the specific issue and the claim that should process for payment.
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    • You may attach documentation to support your request.  All attachments must be in a PDF format.  Up to 10 attachments are accepted.  Each PDF can be up to 40MBs in size; the total of all attachments cannot exceed 150MBs.
    • Only one beneficiary date of service per request.
    • No spreadsheets are accepted.
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  7. Submit your form by entering your name and click the SUBMIT button.

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