The following tools are designed for home health and hospice providers who submit claims to CGS.
|Appeals Timeliness Calculator
||Determine the date your appeal request must be received in order to meet the timeliness guideline.
|CERT Claim Identifier Tool
||Determine the outcome of a CERT reviewed claim, and the reviewer's comments for a claim denied by CERT. Simply enter the Claim Identifier (CID) number assigned to the claim by CERT.
|CGS Provider Enrollment Application Status
||Enter the Reference Number from your acknowledgment letter and the 5-digit Zip code of the contact address to check the status of your enrollment application.
|EDI Report Request Tool
||Allows providers to request a claim response report, or an electronic remittance advice.
|Home Health 60-Day Episode Calendar Schedule
||Assists home health providers in determining the 60th day from the start of care (SOC) date.
|Home Health 60-Day Episode: 2016 Calendar Schedule
||Assists home health providers in determining the 60th day from the start of care (SOC) date for the 2016 calendar.
|Home Health Pre-Claim Review Demonstration Look-Up
||Enter your home health agency’s Provider Transaction Access Number (PTAN) (also known as the CMS Certification Number (CCN)) to see if your agency is impacted by the pre-claim review demonstration in Illinois, Florida, Texas, Massachusetts, and Michigan.
NOTE: As of April 1, 2017, the Pre-Claim Review demonstration will be paused for at least 30 days in Illinois. The demonstration will not expand to Florida on April 1, 2017. Refer to the CMS Pre-Claim Review Demonstration for Home Health Services Web page for additional information.
|Hospice Payment Rates Calculator
||Calculates the standardized Medicare payment amount for each hospice level of care.
|Interactive Medicare Electronic Remittance Advice (ERA)
||This interactive guide provides an overview of the ERA using PC-Print. Select the screen option (below) that you wish to view. As you move your mouse over the area of interest, the field(s) will highlight. Click on the area of interest to view more detailed information.
|Interactive Medicare Standard Paper Remittance (SPR) Advice
||This interactive guide provides an overview of the SPR Advice. Select the section (below) that you wish to view. As you move your mouse over the area of interest, the field(s) will highlight and the name of the field will display. Click on the field to view more detailed information.
|IVR Beneficiary Name to Number Converter
||Converts the beneficiary's first initial of their first name and first six letters of their last name for the IVR beneficiary name validation process.
|Medicare Secondary Payer (MSP) Online Tool
||Decision tree that provides complete billing information based on the type of MSP record.