Ohio Part B Contact Information
All written inquiries – remember to include an "attention to" note on the first page of each written inquiry. This will help us direct your inquiry to the correct department quickly.
You may also contact us online by using our Online Help Center.
Quick Links
- Appeals - Redetermination Requests
- Beneficiary Customer Service Calls
- Carrier Medical Director
- Congressional Inquiries
- Customer Service
- EDI - Electronic Data Interchange
- Fax
- Feedback
- Freedom of Information Act
- General Correspondence
- Investigational Device Exemption Request
- Interactive Voice Response (IVR)
- Overpayment Recovery
- Paper Claim Submission
- Project Officer
- Provider Customer Service Calls
- Provider Enrollment
- Reopenings
Appeals - Redetermination Requests
NOTE: Complete the Medicare Part B Jurisdiction 15 Redetermination Form.
First level appeals are called "Redeterminations". You must request a redetermination in writing within 120 days of the initial claim determination (i.e., the date of your Medicare Remittance Notice detailing the initial claim denial)
J15 — Part B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202
TopBeneficiary Customer Service Calls
1.800.Medicare (1.800.633.4227)
Carrier Medical Director
Carrier Medical Director: Earl Berman, MD
CGS Administrators, LLC
ATTN: Medical Review
Two Vantage Way
Nashville, TN 37228
Phone: 615.660.5423
FAX: 615.664.5971
Congressional Inquiries
For inquiries from a Congressional Office
J15 - Part B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202
Fax: (615)664-5923 (preferred method)
Customer Service
| Ohio Part B Customer Service: | 1-866-276-9558 8:00 a.m. to 5:00 p.m. EST |
Freedom of Information Act
J15 — Part B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202
EDI - Electronic Data Interchange
Telephone:
866-276-9558
Mailing Address for EDI applications and forms:
J15 — Part B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202
Fax number for EDI applications and forms (preferred method):
615.664.5927
Feedback
Should you wish to offer comment to CMS concerning CGS's performance, please write to the address below:
Steven A. Smetak
Contracting Officer's Representative (COR) for the J15 A/B MAC
Western MAC Program Management Division
Medicare Contractor Management Group
Centers for Medicare & Medicaid Services
1600 Broadway, Suite 700
Denver, CO 80202
J15 Project Officer
Melissa Lamb
J15 Project Officer
CGS Administrators, LLC
Two Vantage Way
Nashville, TN 37228
General Correspondence
For all general inquiries and correspondence, please use the following address:
J15 — Part B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202
General Fax Number
615.782.4490
Investigational Device Exemption Request Mailbox
Interactive Voice Response (IVR)
The IVR offers a host of self-service options, including claim status, patient eligibility, check status, and more. Remember, CMS requires providers to use the IVR for these simple inquiries.
- 1-866-290-4036
The IVR is available 24 hours a day, 7 days a week, except for routine system maintenance. However, the most common IVR inquiries also require the IVR to access our online system. The times below represent our online system availability, which means that all IVR options are routinely available during these times:
Monday - Friday: 7:00 am - 7:00 pm ET
Saturday: 7:00 am - 4:00 pm ET
Overpayment Recovery
This unit handles overpayments, voluntary refunds, offsets, lost checks, etc.
Mailing Address for Refund checks:
CGS Administrators, LLC – J15 Part B Ohio
PO BOX 957352
St Louis, MO 63195-7352
OH OPR Fax: 615-664-5926
Paper Claim Submission
For all paper claims, please use the following mailing address:
J15 — Part B/HHH Claims
CGS Administrators, LLC
PO Box 20019
Nashville, TN 37202
Provider Customer Service Calls
For complex inquires that cannot be handled via the IVR and require the assistance of a Customer Service Representative, providers may call our Customer Service unit.
1-866-276-9558
Customer Service is available: Monday - Friday: 8:00 am to 5:00 pm (ET)
TTY/TDD:
1-888-270-9481
Information Needed:
- NPI, PTAN, and Last five digits of Tax ID Number
- Patient Name and Date of Birth
- Health Insurance Claim Number (HICN)
- Date of Service
Provider Enrollment
This unit is responsible for credentialing and enrollment, including changes to existing Medicare providers' records. All telephone inquiries regarding Provider Enrollment should be directed to the main Customer Service telephone number at: 1-866-276-9558.
J15 — Part B Provider Enrollment
CGS Administrators, LLC
PO Box 20017
Nashville, TN 37202
Reopenings
"Reopenings" is a process used to correct minor errors or omissions to a previously processed claim without using the formal appeals process. A reopening must be requested within one year from the date of the initial determination.
| Telephone Reopenings: | 866-276-9558 |
|---|---|
| Written Reopenings: | J15 — Part B Correspondence CGS Administrators, LLC PO Box 20018 Nashville, TN 37202 |
