Corporate

January 29, 2019

Provider Contact Center (PCC) Reminders

The CGS Medicare Customer Service Representatives (CSR) in our Provider Contact Centers (PCCs) often receive misdirected calls because, when prompted, an incorrect option was selected. To help you reach the correct CGS staff to answer your questions, please review the following selections (options) available when you call. In addition, before calling, check out the website resources listed for answers to your questions.

Select:

For questions about:

Option 1: Claims

Claims specific information that requires the CSR to access beneficiary or claim information.  Note:  Providers are required to use self-service technology, such as the Interactive Voice Response (IVR) system or our website portal, myCGS for claim status and beneficiary eligibility information.

Website Resources:

Option 2: Electronic Data Interchange (EDI)

EDI enrollment, connectivity, PC-Ace Pro32, PC Print, or network service vendors. EDI can also answer questions about the annual recertification process for Direct Data Entry (DDE) and Professional Provider Telecommunication Network (PPTN) users.  The DDE/PPTN annual recertification typically occurs July through October.

Website Resources:

Option 3: Provider Enrollment

Provider enrollment application (CMS-855) process, or revalidation of your Provider Transaction Access Number (PTAN), commonly referred to as Medicare provider number. Remember, provider enrollment revalidations generally occur every 5 years.  Check the Medicare Revalidation List to see if you’re due for revalidation.

Website Resources:

Option 4: Overpayment Recovery (OPR)

(Home Health, Hospice and Part A)

Offsets, voluntary refunds, demand letters, credit balance reports or extended repayment plans. 

Website Resources:

Option 4: Telephone Reopening (TRO)

(Part B)

Telephone reopening

Website Resources:

Option 5: Overpayment Recovery (OPR)

(Part B)

Offsets, voluntary refunds, demand letters, credit balance reports or extended repayment plans. 

Website Resources:

Option 9: General Inquiries

Non claim specific information, such as coverage and benefit guidelines, finding CGS or CMS website information, mailing address or telephone numbers, or how to read a remittance advice. 

Visit the Customer Service Web pages for additional information and resources.

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