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What is the best way for me to check the status of my claim?

Providers are required to use self-service technology, such as the Interactive Voice Response (IVR) system, the Fiscal Intermediary Standard System (FISS) via Direct Data Entry (DDE) or the myCGS web portal to access claim status and beneficiary eligibility information. Customer Service Representatives (CSRs) will refer providers to these resources when calling for claims status or eligibility information. Exceptions will be made if your experience technical difficulties.

Interactive Voice Response (IVR) – Use the IVR to check the status of a specific claim by calling 1.877.220.6289 and select Option 1. You will need your facility's NPI, PTAN, and the last 5 digits of the provider TIN. Refer to the Interactive Voice Response (IVR) System Home Health & Hospice IVR User GuidePDF for additional information. Use the Medicare Beneficiary Identifier (MBI) and Name to Number Converter self-service option. This tool converts letters to numbers for easy entry using your telephone keypad.

Fiscal Intermediary Standard System (FISS) via Direct Data Entry (DDE):

  • From the FISS Main Menu, select 01 "Inquiries."
  • From the Inquiry Menu, select 12 "Claim Summary."
  • From the Claim Summary Inquiry screen, enter your facility's NPI number in the NPI field, and the beneficiary's Medicare ID number in the MID field.
  • Press Enter

Refer to the Inquiry MenuPDF (Chapter 3) of the Fiscal Intermediary Standard System Guide for completed instructions on using FISS DDE to check the status of your claim.

myCGS Web Portal – myCGS can also be used to check the status of claims. Refer to the myCGS User Manual, Chapter 2: Claims TabPDF for detailed instructions. If you are not registered to access myCGS, refer to the Chapter 1: Overview of myCGSPDF for additional information.

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