CorporateBusiness Services

Kentucky and 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

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).

Options:

  • Registered users may file Redetermination Requests through our secure web portal, myCGS. Click here to get started and find out more about how to make myCGS work for you.
  • All providers may file Redetermination Requests "on paper." Access the online Redetermination Request formPDF and complete it electronically, then print and sign the form, attach supporting documentation, and mail it to:

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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Contractor Medical Director

Contractor Medical Director: Earl Berman, MD
CGS Administrators, LLC
ATTN: Medical Review
Two Vantage Way
Nashville, TN 37228

Clinical questions should be submitted in writing to cmd.inquiry@cgsadmin.com or faxed to 615.664.5971.

All other questions should be directed to customer service who will forward your inquiry to the appropriate area.

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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)664-5913 (preferred method)

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Customer Service: Providers

For complex inquiries that cannot be handled via the IVR and require the assistance of a Customer Service Representative, call our Customer Service unit at 866.276.9558. We are available to assist you from 8 a.m. – 5 p.m. ET, Monday-Friday.When Options 1-4 are selected, the Computer Telephony Integration (CTI) system will prompt you for information in order to validate your provider and beneficiary information. Be prepared and have the following information available before you call. Option 9 is only used for general questions not related to claim specific topics.

  • NPI, PTAN, and last five digits of Tax ID Number
  • Patient name, date of birth, Health Insurance Claim Number (HICN), and the date of service (if applicable)

    Option 2

    Specialized assistance regarding Electronic Document Interchange (EDI)

    Option 3

    Dedicated help regarding Provider Enrollment, credentialing, and revalidation questions

    Option 4

    Request a telephone reopening

    • See more under "Reopenings" on this web page
    Option 5

    Expert assistance with questions involving overpayments and refunds

    Option 9 For assistance with a general question. 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.
    Option 1

    All other inquiries requiring assistance from a Customer Service Representative, including:

    • Help with claim denials
    • Locating and understanding claim submission requirements
    • Finding information on the CGS website
    • Understanding how payments are calculated

TTY/TDD:

1-888-270-9481

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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

Reach a specialized EDI representative by telephone: call 866.276.9558 and select Option 2

Mailing Address for EDI applications and forms:

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

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

Kentucky Fax number for EDI applications and forms (preferred method):
615.664.5917

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Feedback

Should you wish to offer comment to CMS concerning CGS's performance, please write to the address below:

Margot Warren, CPA
Medicare Contractor Management Group
J15 Contracting Officer's Representative
Centers for Medicare & Medicaid Services
1961 Stout St. Rm 08-148
Denver, CO 80294

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.

  • 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

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Overpayment Recovery

This unit handles overpayments, voluntary refunds, offsets, lost checks, etc.

Registered users can request automatic offsets through our secure web portal, myCGS. Click here to get started and learn more about how to make myCGS work for you.

Mailing Address for Refund checks:

Kentucky:
CGS Administrators, LLC – J15 Part B Kentucky
PO Box 957065
St. Louis, MO 63195-7065
KY OPR Fax: 615-664-5916

Ohio:
CGS Administrators, LLC – J15 Part B Ohio
PO BOX 957352
St Louis, MO 63195-7352
OH OPR Fax: 615-664-5926

If you have a question regarding an overpayment or refund, you may reach a specialized representative by calling 866.276.9558 and select Option 5.

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Paper Claim Submission

Attention Part B paper claim submitters: Part B claims can now be submitted for free online through myCGS. Click here for details.

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 Enrollment

  • This unit is responsible for credentialing and enrollment, including changes to existing Medicare providers' records.
  • To reach a specialized Provider Enrollment Customer Service Representative, call 866.276.9558and select Option 3.
  • Mailing address:

    J15 — Part B Provider Enrollment
    CGS Administrators, LLC
    PO Box 20017
    Nashville, TN 37202

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Reopenings

  • A "reopening" refers to a request 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.

Options:

  • Registered users may file Reopening Requests through our secure web portal, myCGS. Click here to get started and find out more about how to make myCGS work for you.
  • Some reopening requests can be handled via telephone. Access the Reopenings vs. Redeterminations job aidPDF to find out whether your request qualifies. If so, call us at 866.276.9558 and select Option 4 to make your request.
  • All providers may file Reopening Requests "on paper." Access the online Reopening Request form and complete it electronically, then print and sign the form, attach supporting documentation, and mail it to:

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

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Updated: 07.1.16


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