February 23, 2024
Save Time When You Call Customer Service
When you call CGS Customer Service, we must follow specific rules before disclosing protected health information (PHI) or personally identifiable information (PII). We can only release PII or PHI if you need it to treat a patient, bill correctly, or get paid for items or services provided. You must provide specific information to confirm the relationship.
To help speed up the amount of time it takes to reach a Customer Service Representative (CSR), use the Computer Telephone Integration (CTI) system. CTI is a system that allows you to securely and privately answer questions to authenticate the provider and verify the beneficiary. When you call the customer service line, just follow the prompts and enter the information using your telephone keypad. The system will automatically transfer you to a CSR after it verifies the required elements.
Starting March 1, 2024, CSRs will no longer authenticate information verbally over the phone. We will transfer callers back to the CTI line for authentication.
Use the MBI Letters to Numbers Converter and Beneficiary Name to Number Converter to help convert letters to numbers when using your telephone keypad.
You must authenticate the following elements before speaking to a CSR:
- Provider National Provider Identifier (NPI)
- Provider Transaction Access Number (PTAN)
- The last five digits of the provider Tax Identification Number (TIN)
- Medicare Beneficiary Identifier (MBI).
- Beneficiary's first initial
- Beneficiary's last name – Enter up to six letters followed "#" sign (ignore any spaces)
- The beneficiary's date of birth.
- Date of service (when needing claim information).
CMS requires suppliers and providers use self-service technology to access claim status, payment, and beneficiary information. Customer service may only provide information if it cannot be obtained through the myCGS Web Portal or Interactive Voice Response (IVR) system. Beneficiary and claim information are available in myCGS and the IVR Monday - Friday, 6 am - 9 pm CT and Saturday, 6 am - 4 pm CT.
Other Self-Service Tools on the JB Website
The JB DME website is an important self-service tool and source for education about the Fee-for-Service (FFS) Medicare program, DMEPOS policies and guidelines. The Tools & Calculators section lists interactive tools and calculators to help navigate DMEPOS billing and resolve errors including:
- Advanced Modifier Engine (AME)
- CGS Wizard
- Claim Denial Resolution Tool
- DMEPOS Fee Schedule Search Tool
- Remittance Advice Instructions Tool
- Same/Similar Code Lookup
The Supplier Manual outlines general questions about DME claims submission and processing. This is an up-to-date instruction that answers to most general Medicare questions.
Review Local Coverage Determinations (LCDs) and related policy articles for coverage, coding, and documentation guidelines.