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Jurisdiction C Contact Information

Department

How to Contact

Forms/Instructions

Customer Support

Interactive Voice Response (IVR): 866.238.9650

Phone: 866.270.4909

Hearing Impaired/TTY: Dial 711

Written Inquiries Fax: 615.782.4490

Mailing Address:

CGS – Jurisdiction C Written Inquiries
PO Box 20010
Nashville, TN 37202

Online Help Center

Hours: Monday through Friday from 7 am - 5 pm CT/8 am - 6 pm ET

CMS requires suppliers and providers use self-service technology to access claim status, payment, and beneficiary information. The myCGS DME Web Portal and IVR system are two self-service technologies that allow suppliers to easily access beneficiary and claim information.

Phone Calls: Claim and eligibility-specific calls to the Provider Contact Center (PCC) must be authenticated through the Computer Telephone Integration (CTI) systemPDF. CSRs will no longer authenticate information verbally over the phone. We will transfer callers back to the CTI line for authentication.

Please be prepared to enter all pertinent information related to your inquiry using the CTI system, including:

  • NPI
  • PTAN
  • Last five digits of your tax ID number (TIN)
  • The beneficiary's Medicare Beneficiary Identifier (MBI), DOB, and DOS.
  • Your name and phone number

Tip: Use the MBI Letters to Numbers Tool to convert letters to numbers for use on your telephone keypad.

Written Inquiries: Please state your question or concern as clearly as possible, including all pertinent information:

  • NPI number
  • PTAN
  • If appropriate, the beneficiary's name, Medicare Beneficiary Identifier (MBI), and date of service.
  • Your name and phone number
  • Last five digits of Tax ID

Note: We are unable to respond to email inquiries containing sensitive information such as MBI or Tax ID.

Customer Support Webpage

Additional Documentation Request (ADR)

Fax: 615.782.4624

Mailing Address:
CGS – Jurisdiction C Medical Review
PO Box 20010
Nashville, TN 37202

Refer to the ADR Process for more information.

Advanced Determination of Medicare Coverage (ADMC)

myCGS Web Portal: Click here to get started

Fax: 615.782.4647

Mailing Address:
CGS – Jurisdiction C ADMC
PO Box 20010
Nashville, TN 37202

ADMC Request FormPDF

ADMC Webpage

Claim Submission (Paper CMS-1500 Claim Forms only)

Mailing Address:
CGS – Jurisdiction C Claims
PO Box 20010
Nashville, TN 37202

Refer to Claim Submission and Paper Claims for more information about how to use and obtain paper claim forms from the U.S. Government Bookstore—Purchase Paper Claim FormsExternal Website.

See also: Electronic Claims

Overpayments & Refunds

Fax: 615.782.4477

Mailing Address:
CGS Administrators, LLC – DME JC
PO Box 955152
St. Louis, MO 63195-3479

Overnight Delivery:

Through October 13, 2023:

CGS Administrators, LLC - DME JC
Lockbox 955152
1005 Convention Plaza
SL-MO-C1WS
St Louis, MO 63101

Beginning October 14, 2023:

CGS Administrators, LLC - DME JC
Lockbox 955152
3180 Rider Trail South
SL-MO-R1LB
Earth City, MO 63045

Offset Request FormPDF
Overpayment Recovery Request FormPDF
Voluntary Overpayment Refund FormPDF

Refer to Overpayment Recovery for more information.

Prior Authorization

myCGS Web Portal: Click here to get started

Fax: 615.664.5960

Mailing Address:
CGS – Jurisdiction C Medical Review Prior Authorization
PO Box 24890
Nashville, TN 37202-4890

esMD: (indicate document type "8")

Prior Authorization (PA) Submission FormPDF

Refer to Prior Authorization for more information.

Redeterminations (Appeals)

myCGS Web Portal: Click here to get started on redetermination request submission.

Fax: 615.782.4630

Redeterminations Mailing Address:
CGS – Jurisdiction C Redeterminations
PO Box 20009
Nashville, TN 37202

*Contact information above is for Overpayment Appeals as well.

Refer to Appeals for detailed instructions on appealing claims and overpayments.

Redetermination Completion GuidePDF
Redetermination Request (Level 1)PDF

Reopenings (Claims Corrections & Adjustments)

myCGS Web Portal: Click here to get started on claim correction or reopening form submission.

Reopenings Phone: 866.813.7878

Underpayment Fax: 615.782.4649
Overpayment Fax: 615.782.4477

Mailing Address:
CGS – Jurisdiction C Written Reopenings
PO Box 20010
Nashville, TN 37202

Refer to Reopenings for detailed instructions on requesting reopenings for minor errors and omissions.

Reopening Request Form Completion GuidePDF
Reopening Request FormPDF

Other Contacts

People with Medicare (Beneficiary Customer Service)

Phone: 1.800.MEDICARE (800.633.4227)
Hearing Impaired/TTY: 1.877.486.2048

www.medicare.govExternal website

Benefits Coordination & Recovery Center (BCRC), formerly known as COBC

Customer Service: 1.855.798.2627

Written Inquiries:
Medicare – MSP General Correspondence
P. O. Box 138897
Oklahoma City, OK 73113-8897

When to contact the BCRC:

  • To ask a general MSP question.
  • To ask a question regarding the MSP letters and questionnaires (i.e. IEQ and Secondary Claim Development (SCD) questionnaires.)

You may contact the BCRC by calling a Customer Service Representative or through Written Correspondence.

CMS-Benefits Coordination & Recovery Center (BCRC)External website

CEDI (Electronic Data Interchange)

CEDI Helpdesk Phone: 866.311.9184

Email: ngs.cedihelpdesk@anthem.com

www.ngscedi.comExternal website

Contact CEDI regarding: Electronic Claim Submission, Electronic Remittance Notices, and 276/277 transactions

CGS Headquarters

Address:
CGS Headquarters
26 Century Blvd., Ste ST610
Nashville, TN 37214-3685

Competitive Bidding Implementation Contractor (CBIC)

Beneficiaries should call 1.800.MEDICARE (1.800.633.4227) for assistance with questions about the competitive bidding program or claims.

Suppliers or referral agents who have questions about the competitive bidding program should contact the CBIC: 877-577-5331

Competitive Bidding Implementation Contractor (CBIC) websiteExternal Website

Comprehensive Error Rate Testing (CERT)

Mailing Address:
CERT Documentation Center
8701 Park Central Drive, Suite 400-A
Richmond, VA 23227

Fax: 804.261.8100

Toll Free Phone: 888.779.7477

Email: CertProvider@empower.ai

CERT C3HUB web siteExternal Website

Electronic Funds Transfer (EFT)

Mailing Address:
See National Provider Enrollment (NPE) East or NPE West

Electronic Funds Transfer (EFT) Authorization FormExternal PDF
NOTE: This form must be mailed in with original signatures and banking information.

Freedom of Information Act (FOIA)

Mailing Address:
Attn: DME MAC Freedom of Information Coordinator
Suite ST610
26 Century Blvd
Nashville, TN 37214

Refer to Supplier Manual: Chapter 1 - Introduction (DME MAC Jurisdiction C)PDF for additional information and examples.

All FOIA requests are subject to fees for search, review, and copy/duplication. Before submitting your request, you may want to see if the information can be obtained from our website.

National Provider Enrollment (NPE) East
Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands)

Phone:866-520-5193

Provider Enrollment Status Inquiry ToolExternal website

Mailing Address:
Novitas Solutions, Inc.
PO Box 3704
Mechanicsburg, PA 17055-1863

National Provider Enrollment (NPE) East (Novitas Solutions)External Website

National Provider Enrollment (NPE) West  
Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands

Phone: 866.238.9652

Email National Provider Enrollment (NPE West)External website

Mailing Address:
National Provider Enrollment (NPE) West
Palmetto GBA
AG-495
PO Box 100142
Columbia, SC 29202-3142

National Provider Enrollment (NPE) West (Palmetto GBA)External Website

Office of Inspector General (OIG) to
report fraud and abuse

File a Complaint OnlineExternal website

Phone: 1.800.HHS.TIPS (1.800.447.8477)

TTY Phone: 1.800.377.4950

Mailing Address:
U.S. Department of Health and Human Services
Office of Inspector General
ATTN: OIG HOTLINE OPERATIONS
PO Box 23489
Washington, DC 20026

OIG HotlineExternal website

Pricing, Data Analysis, and Coding (PDAC)

Contact Center Phone: 877.735.1326

Medicare Pricing, Data Analysis and Coding (PDAC)External Website

Reconsiderations (Appeals)

Durable Medical Equipment (DME) Qualified Independent Contractor (QIC) for second level independent external reviews of Medicare Fee-for-Service healthcare denials.

Mailing Address:
Maximus Federal Services, Inc.
Medicare DME
3750 Monroe Avenue
Suite 777
Pittsford, NY 14534

Phone: 585.348.3200

Email: DMEInfo@MAXIMUS.com

MAXIMUS Federal ServicesExternal Website

Recovery Auditor (RAC)

Phone: 866.201.0580

Performant Recovery, Inc.External Website

Supplemental Medical Review Contractor (SMRC)

Phone: 1.833.860.4133

Email: SMRCMail@Noridian.com

Supplemental Medical Review Contractor (SMRC)-Noridian Healthcare Solutions, LLC (NHS)External Website

Supplier Enrollment
National Supplier Clearing House (NSC)

Starting November 7, 2022, 2 contractors will process Medicare enrollment applications for DMEPOS suppliers to make sure they meet all supplier standards and enrollment requirements.

Refer to National Provider Enrollment (NPE) East or National Provider Enrollment (NPW) West above.

 

The Centers for Medicare & Medicaid Services (CMS)

Toll-Free Phone: 877.267.2323

Local Phone: 410-786.3000

TTY Toll-Free Phone: 866.226.1819

TTY Local Phone: 410-786-0727

CMS Website

 

Other Helpful Links

CMS

DME MACs

  • Jurisdiction A – Noridian Healthcare SolutionsExternal website – Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont
  • Jurisdiction B – CGS – Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin
  • Jurisdiction C – CGS – Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia
  • Jurisdiction D – Noridian Healthcare SolutionsExternal website – Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, and Wyoming

Remittance Advice Reason CodesExternal Website

Unified Program Integrity Contractors (UPIC)

CoventBridge Group – UPIC Midwestern (Unified Program Integrity Contractor) for IA, IL, IN, KS, KY, MI, MN, MO, NE, OH, & WIExternal Website

Qlarant – UPIC Southwest (Unified Program Integrity Contractor) for AR, CO, LA, MS, NM, OK, & TXExternal Website

Safeguard Services, LLC – UPIC Southeast Unified Program Integrity Contractor) for AL, FL, GA, NC, PR, SC, TN, VA, VI, & WVExternal Website

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