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November 22, 2016

Coming Soon - myCGS Part B Provider Self-Service Reopenings

myCGS self service Reopenings, Part B providers will be able to quickly correct minor clerical errors themselves from myCGS. Currently when a provider submits a Reopening they have to complete a form identifying the simple clerical error they would like to have corrected then submit the form through myCGS for an analyst to work.  Soon there will be no forms to complete, no waiting for CGS to review your submitted request form. That’s right! You will be able to access your claim to make the simple clerical error change yourself, once you have signed onto myCGS and selected the Reopening tab.

Modifier Reopening:

  • Providers will be able to add, replace or delete a modifier (any of these three actions) when the claim denied for one to of the above modifier clerical errors. You will be able to bypass completing the reopening form and go directly to the denied claim, apply the modifier correction and the claim will then process for payment.

Cancel Claim Retrieval:
Claims that have been submitted in error, you will now be able to retrieve the claim and acknowledge that the claim was submitted in error and receive a message that the claim has been removed in addition;

  • If the claim was submitted in error, and a Medicare payment was made, the provider can acknowledge payment was made in error and an overpayment will automatically be setup for the Whole claim only.
    • Future enhancements will be added to do detail lines, but for now this new enhancement is only available to do the entire claim as an overpayment or remove from the system and provide a confirmation code advising of the correction.

Future automated adjustment enhancements, will be available in 2017

  • Diagnosis Code
  • Procedure Code and/or Billed Amount (Both together or one individually)
  • Date of Service corrections
  • Cancel detail line claims

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