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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.

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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 A/ B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202

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Beneficiary Customer Service Calls

1.800.Medicare (1.800.633.4227)

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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

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Congressional Inquiries

For inquiries from a Congressional Office

J15 — Part A/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

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Freedom of Information Act

J15 — Part A/ B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202

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EDI - Electronic Data Interchange

Telephone:
866-276-9558

Mailing Address for EDI applications and forms:
J15 — Part A/ B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202

Fax number for EDI applications and forms (preferred method):
615.664.5927

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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 A/B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202

General Fax Number

615.782.4490

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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.

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

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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

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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

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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:

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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

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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 A/ B Correspondence
CGS Administrators, LLC
PO Box 20018
Nashville, TN 37202

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Updated: 03.22.13


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