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Claim Status & Remittance Advice/Payment Information

CMS requires suppliers and providers use self-service technology to access claim status, payment, and beneficiary information. Using self-service technology will save you time. There is no need to call and speak to Customer Support.
You may use the following options for claim status:

Claim Status Inquiry (CSI)

Claim Status Inquiry (CSI) allows you to electronically check the status of production claims after they have passed the front-end edits and received a Claim Control Number (CCN).

A gateway connection with a Network Service Vendor must first be set up. CGS has agreements with the following Network Service Vendor:

Inovalon Network Contact: 1.612.460.4327 

General Inquiries: 1.877.340.5610 

The service provider will give downloading instructions, a login ID, and a password to access the gateway via a dial-up phone number (modem) or an IP address to use via FTP (file transfer protocol).

Once you have successfully signed up with a Network Service Vendor, please complete the CSI User ID Access Request FormPDF to receive a user ID and password. You can fax the this form to 615.782.4626 or mailed to CGS, ATTN: VPIQ, PO Box 20010, Nashville, TN 37202. It is important to note that you will need two user IDs and passwords to access the CSI system – one from the Network Service Vendor and one from CGS.

For more details regarding Claim Status, please see the Claim Status Inquiry User GuidePDF.

Claim Status Inquiry (CSI) Annual Recertification

CGS  implemented an annual recertification process that requires users to complete the CSI Recertification FormPDF every year. This new process started in April 2023. If you have not submitted a CSI Recertification FormPDF since April, you must complete a new form by July 31, 2023. If you do not send the recertification form prior to July 31st, 2023, your access will be deactivated, and you will need to re-register to continue access to the CSI application.

Please make sure to complete all fields to ensure there are no issues.

If you currently have access in both Jurisdiction B and Jurisdiction C, you will only need to send one form. Please be sure to include all NPI/PTANs that you need to continue to have access to.

Software Vendor, Billing Service or Clearinghouse

The Common Electronic Data Interchange (CEDI) Contractor publishes an Approved Entities List,  CEDI Enrollment information on the NGS CEDIExternal Website website.

Electronic Remittance Advice/Claim Payment Information

Claim payment information is available electronically the same day your claim is finalized.

If you would like to start receiving electronic remittance advice (ERA) instead of receiving the paper explanation of benefits, follow the below steps:

  1. Verify you can receive the 835-transaction file. If you are a self-biller, verify this information with your software vendor. If you are using a third party biller, verify the information with your billing service/ clearinghouse. You will need a Network Service Vendor (NSV) to receive the ERA from CEDI.
  2. Complete the CEDI Guided Enrollment Process to enroll in CEDI or to add Health Care Payment/Advice (835 v5010A1) to an existing enrollment.
  3. You will receive an e-mail confirmation when CEDI completes your request. You will begin to see the electronic remit files at once. If your software vendor, billing service, or clearinghouse is able to receive the electronic remittance advise 835 file but does not have a program to translate it into a readable format, the Centers for Medicare & Medicaid Services does offer a free software called free Medicare Remit Easy Print (MREP) SoftwareExternal Website.

Updated on 04.24.24

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