Corporate

July 10, 2018

Introducing the myCGS MR Dashboard!

When we process claims, occasionally our Medical Review (MR) department staff will need additional documentation from you in order to make a decision.  This includes operative reports, plans of care, radiology/diagnostic reports, and other medical records. If/when the need arises we will send you an additional documentation request (ADR) letter identifying the documentation needed to continue processing your claim.

For your convenience, myCGS now has an MR Dashboard available to you to QUICKLY identify MR ADRs sent to you!  As an added convenience, you will be able to respond to pending ADRs by sending your documentation to us directly from the MR Dashboard!

To access your MR Dashboard:

  • Once you are logged into myCGS, select the ‘Medical Review’ tab.
  • ADR letters sent from our MR department will be listed by claim number (Document Control Number (DCN)) assigned to the actual claim.

    Screen Shot

  • The ADR Status column gives you details about the ADR request.  Statuses include:
    • PENDING: This claim is pending a response to our ADR request.
      • On ADRs with a PENDING status, you may select the option listed under ACTION to attach your medical records to the MR ADR Response Form and send your response electronically.
    • RESPONSE RECEIVED: We received your response to the ADR from your office.
    • MED REVIEW BEGUN: Our MR staff began reviewing the ADR and the documentation submitted with your response.
    • REVIEW RESULTS SENT: The review was completed.
    • PROCESSING: The claim is no longer pending for medical review.
    • CASE CLOSED: The claim has been released from medical review and is continuing through the claims processing system. Could also indicate your claim has denied for non-response to the ADR request.

Take advantage of this enhancement and a number of additional myCGS functions available to you.

Not currently using myCGS?  Register TODAY!

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