CMS requires all Medicare contractors to have a Provider Customer Service Program (PCSP) to assist providers in understanding and complying with Medicare's operational processes, policies, and billing procedures. The primary responsibility of the PCSP is to enable providers to understand, manage, and bill the Medicare program correctly, with the goal of reducing the Medicare paid claims error rate and improper payments.
Before you call:
- Check the CGS website; the answers to many of the most common questions are found here. Tip: narrow your search results to include only "Part B" articles.
- FAQs and articles located in Browse by Specialty and Browse by Topic are good resources.
- Obtain information electronically (including duplicate copies of remittance advices, extensive beneficiary eligibility information, and even file offset requests and first-level appeals (redeterminations)) through our free web portal, myCGS. Tip: you must have an EDI enrollment agreement on file with CGS to register for and use this portal. If you submit claims to us electronically, we have an agreement on file for you.
- Call the Interactive Voice Response (IVR) Unit at 866.290.4036 to obtain information on claim status, redetermination status, beneficiary eligibility information, and information on Medicare checks.
- Provider Contact Center (PCC): for assistance from one of our knowledgeable and friendly CSRs, for information not available through the IVR, call 866.276.9558. Our PCC is your best, first point of contact for information not available on the CGS website or through our web portal or IVR. Reach the correct representatives quickly by selecting the right option. Before reaching the CSR, the Computer Telephony Integration (CTI) system will prompt you for information in order to validate your provider and beneficiary information.:
Specialized assistance regarding Electronic Document Interchange (EDI)
Dedicated help regarding Provider Enrollment, credentialing, and revalidation questions
Request a telephone reopening
- Some reopening requests can be handled via telephone. Access the Reopenings vs. Redeterminations job aid to find out whether your request qualifies. If so, call us at 866.276.9558 to make your request.
- If your reopening request cannot be made by telephone:
Expert assistance with questions involving overpayments and refunds
||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.
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