Corporate

March 26, 2019

myCGS Additional Documentation Request (ADR) and General Questions

The home health and hospice Provider Contact Center (PCC) has seen where general questions about claims in the return to provider (RTP) file or rejected claims are submitted via myCGS using the Medical Review tab.   Please review the following in order to ensure your information is directed to the correct department. 

Forms Tab

The myCGS “Forms” is used to submit general inquiries to the PCC.  From the “Select a Topic” drop down menu, select Provider Contact Center.  A link to the “General Inquiry Form: PC-J15-HHH-5500” will display.  Click the link to access the General Inquiry form for you to complete.  Do not submit Medical Review related inquiries using the Provider Contact Center topic.  Refer to the myCGS General Inquiry – HHH article for additional information.

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Medical Review ADRs

  • Forms Tab - Medical Review ADRs can also be submitted from the Forms tab; however, submitting Medical Review ADRs via the Medical Review dashboard allows for additional functions.
  • Medical Review Tab - A response to a Medical Review ADR or a question can be submitted from the Medical Review tab.  Refer to the Responding to Requests for Additional Documentation Through myCGS article for additional information.
    • Ask a Question Button - Once you select a claim number shown in the Claim # field, claim status information will display.  You will also see the button “Ask a Question”.  Select the “Ask a Question” only for questions regarding the MR ADR.  In addition, do not use the “Ask a Question” to respond to a pending ADR.

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Additional myCGS resources are available on the myCGS Web page, and on the myCGS User Manual Web page.

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