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Top Provider Contact Center Telephone Inquiries

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. A resource available to you to meet this requirement is the Provider Contact Center (PCC).

Before contacting the PCC, be sure to review the contact information on the Home Health & Hospice Customer Service Phone/Fax web page so that you reach the correct department.

For your convenience, we offer a comprehensive list of Frequently Asked Questions (FAQs). If you have a question, save yourself some time and check the FAQs first!

Below is a list of the top reasons why providers contacted us.

Top Telephone Inquiries: June 2021

Primary Reason and Secondary Reason Monthly Total Resource/Reference
RTP/Unprocessable Claim:
Contractual Obligation Not Met
431

Prevent your claims from going to the return to provider (RTP) file (status/location T B9997) and ensure that all the required billing elements are submitted. Resources for home health and hospice providers include:

When your claim is in the return to provider (RTP) file (status/location T B9997) you must make the necessary correction to allow the claim to continue processing. Refer to the following CGS website resources for assistance:

RTP/Unprocessable Claim:
Missing/Invalid Codes
212

Prevent your claims from going to the return to provider (RTP) file (status/location T B9997) and ensure that all the required billing elements are submitted. Resources for home health and hospice providers include:

When your claim is in the return to provider (RTP) file (status/location T B9997) you must make the necessary correction to allow the claim to continue processing. Refer to the following CGS website resources for assistance:

Administrative Billing Issues:
Filling/Billing Instructions
203

For information about filing and billing your Medicare claims refer to the CGS Claims web page to access home health and hospice claim filing resources. If you enter your claims via Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE), refer to the FISS DDE Guide. Additional resources include:

Provider Enrollment:
Provider Eligibility
92

The CGS Home Health & Hospice Provider Enrollment web page offers several resources to assist you with provider enrollment.

If you are enrolling in Medicare for the first time or making changes to your existing enrollment information using paper forms, refer to the Home Health & Hospice Provider Enrollment Interactive Help Tool. The Provider Enrollment Tools, Tracking & Resources web page includes the “Status Checker” where you can easily obtain the current status of your provider enrollment application.

If you need to speak with a Provider Enrollment specialist, please call 1.877.299.4500 and press option 3.

Provider Enrollment:
Provider Enrollment Requirements
89

The CGS Home Health & Hospice Provider Enrollment web page offers several resources to assist you with provider enrollment.

If you are enrolling in Medicare for the first time or making changes to your existing enrollment information using paper forms, refer to the Home Health & Hospice Provider Enrollment Interactive Help Tool. The Provider Enrollment Tools, Tracking & Resources web page includes the “Status Checker” where you can easily obtain the current status of your provider enrollment application.

If you need to speak with a Provider Enrollment specialist, please call 1.877.299.4500 and press option 3.

Posted 07.14.21

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