Corporate

March 7, 2019

Process Improvements Based On Your 2018 MSI Survey Feedback!

Your voice was heard and appreciated. We made improvements within the past year in response to your comments in the 2018 Medicare Administrator Contractor (MAC) Satisfaction Indicator (MSI) Survey feedback results. Based on your feedback, CGS enhanced the following.

Appeals:

Audit & Reimbursement:

Claims

Medical Review (MR):

  • In an effort to assist providers with the Targeted Probe and Education Process as well as self-audit activity, two new Medical Review provider resource tools were posted the CGS website.
  • In response to provider feedback regarding clarity of reason for medically reviewed denied claims, Medical Review updated review results letters to provide more detailed denial rationale information.
  • Our goal is to ensure you receive the most benefit from your medical review educational experience. That's why CGS's Medical Review educators updated processes in order to provide clear and consistent information, offering resources and tools, and answering and following up on provider questions.
  • You asked for more web based educational opportunities! Check out the recorded webinars on our website for many clinical educational opportunities including Additional Development Request (ADR) tips and specialties such as Chiropractic, Ambulance, and Podiatry! And stay tuned for more…
  • Here's all you need in order to always know the date you need to submit your Additional Development Request (ADR) documentation. Access the Additional Development Request Timeliness Calculator and determine the date your documentation must be received by CGS.

myCGS Web Portal:

CGS is continually working to enhance our provider web portal based on your feedback. Here are a few of our recent enhancements.

  • Additional functions were added to the Claim Status page that allows you to:
    • Submit a Redetermination (1st level of appeal)
    • Request a Part B Reopening of the claim
    • Respond to a request for additional documentation
    • View CARC and RARC Codes and definitions
    • Ask questions regarding the claim
  • The Medical Review (MR) Dashboard was developed to quickly identify MR additional documentation requests (ADRs). Under the Medical Review tab, review the ADR status, select a claim number to receive detailed claim information beginning at the point of the ADR pending to the medical review status, outcome, and allowing you to request a redetermination (1st level of appeal).
  • The Eligibility tab was enhanced to allow immediate access to your patient's history to see if Medicare Diabetes Prevention Program (MDPP) services were provided and helps you determine the next available date for certain MDPP services.
  • The Eligibility tab was enhanced to allow access to diagnosis codes associated with Medicare Secondary Payer (MSP) insurance type such as worker's compensation, automobile, and liability situations.
  • A new myCGS STATUS button was added to the top right of the Part A, Part B, and HHH website. When the myCGS STATUS button shows green, the web portal is up and running normally, yellow means there's an issue with some aspect of myCGS and when it shows as red, the myCGS web portal is not functional. Simply click on the button to access details of the issue.

Access the December 19, 2018, myCGS Enhancements WebinarExternal Website recording for additional information.

Provider Contact Center (PCC):

  • No more searching for our contact number! For easy access, we made the telephone numbers to the PCC and to call the Interactive Voice Response (IVR) system available on the top of every Web page.
  • We know the new Medicare Beneficiary Identifier (MBI) format can be difficult to enter when using the Interactive Voice Response (IVR) or the Computer Telephone Integration (CTI). Therefore, we created the IVR and CTI Converter Tools which converts the beneficiary's name and Medicare number for easy entry on your telephone keypad.
  • In addition to the monthly PCC trainings set aside for our customer service representatives (CSRs), we continually review the top 10 telephone inquiries and have update internal tools to improve CSR consistency and 1st call resolution to better serve you.

Provider Enrollment:

CGS is continually strives to make the provider enrollment process a smooth process for providers. Therefore, we have focused on our communication to you and developed educational tools and resources.

Provider Outreach and Education (POE):

  • Have you noticed our enhanced webinars and ask-the-contractor teleconferences? In order to answer questions on the spot, we have added operational area subject matter experts to our webinars! We also now give you the opportunity to ask questions when registering for an event. This has allowed us to ensure we include all information you feel is important and have answers ready!
  • If you frequently visit our Calendar of Events web page, you may have noticed that we have significantly increased our educational events offerings! We heard your feedback, and we are out and about! Make sure you stay up to date on where we will be next or what webinar topic we have coming…
  • Did you miss an event?? Don't worry! We have recorded and posted many of our previous webinars! Check them out at the top of the Calendar of Events page!
  • We are constantly enhancing our search engine in order to provide you the best results! In the past year, some of our enhancements included a language prediction tool that provides suggestions as you type in a search term, search misspelled words, a no results message and search tips to help you find exactly what you are looking for.

Coming Soon: 2019 MAC Satisfaction Indicator (MSI)

If you liked these changes recently made or have more to suggest, let us know!! It is because of your feedback that we were able to accomplish these improvements. The 2019 MAC MSI survey is coming in March and this is the best opportunity to share your opinion with CGS and CMS! Be on the lookout for the survey in the next few days!

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