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June 29, 2016 - Updated 09.30.16

Computer Telephony Integration (CTI) System

The CTI system provides a streamline process in which providers will enter authentication information before reaching a Customer Service Representative (CSR). The following explains what providers can expect once the CTI is implemented.

When you call the CGS Part A Provider Contact Center (PCC) (866.590.6703) you will be asked to choose one of the following options. Please note Option 9 is NEW.

Note: You must have your facilities National Provider Identifier (NPI); Provider Transaction Access Number (PTAN); the last 5 digits of the Provider Tax Identification Number (TIN) readily available before selecting the following options. 

 

  • Option 1 – to reach a Customer Service Representative (CSR) for assistance with Beneficiary eligibility, billing or claim information
  • Option 2 – to reach an Electronic Data Interchange (EDI) CSR for assistance with EDI enrollment, connectivity, PC-Ace Pro 32, trading partners, and myCGS
  • Option 3 – to reach the Provider Enrollment department for assistance with enrollment applications, enrollment revalidation, or electronic funds transfer enrollment
  • Option 4 – to reach the Overpayment Recovery (OPR) department for assistance with overpayment issues or question about Credit Balance withholding.
  • Option 9 NEW – Press this option if you have a general question.   NOTE:  Refer to the “General or Claim Specific Questions When Calling the Provider Contact Center” article to determine if your question is considered a general question.

When you choose Options 1 through 4, you will be prompted to enter the following information.  This is the same information you would typically provider verbally to the CSR. 

  • Facility’s National Provider Identifier (NPI),
  • Facility’s Provider Transaction Access Number (PTAN),
  • Last five digits of your Tax ID number
  • Beneficiary’s Medicare Health Insurance Claim (HIC) number (not applicable for Options 2 and 3)
  • First letter of the beneficiary’s first name
  • First six letters of the beneficiary’s last name (Refer to the “IVR Beneficiary Name to Number Converter”)
    • If the last name is less than six characters and there is a suffix, enter the suffix with no spaces. Example:  The first six letters entered for John Bene Jr would be Benejr.
  • Beneficiary’s date of birth

The CTI will authenticate the information entered.  Once authenticated, the information will display on a screen for the CSR to view.  Your call will be transferred to an available CSR who will be ready to assist you with your question. 

When you choose Option 9, you will be routed directly to the CSR in the PCC for assistance.  Please note that Option 9 is only for general questions.  If your question is related to a specific claim, the CSR will direct you to call back and select Option 1.

Incorrect Information Entered
If information is entered incorrectly, the CTI will ask that you reenter the information.  If entered incorrectly three times, the CTI will transfer the caller to a CSR.  Although, you will reach a CSR, if the beneficiary identifying information is entered incorrectly, you will be asked to call back and enter the correct information in the CTI. 

As you know, providers are allowed to ask up to three questions.  If you have a question that is related to a beneficiary that is different than what was entered in the CTI, the CSR will ask you to authenticate the other beneficiary information in order to answer your question. 

The CTI allows validation of one PTAN entry per call; therefore, if you have questions that involve multiple PTANs, you will need to call back. 


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