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CGS Administrators, LLC

IVR: 866.238.9650 Customer Service and myCGS: 866.270.4909

September 13, 2019

Important Information Regarding Telephone Claim Denial Resolutions

CGS is making some changes in regards to claim denial resolutions over the phone.

Historically, suppliers have had the option to get claims resolved over the phone which appeared to have denied in error. If the DME MAC cannot clearly identify the claim denied in error, you will be asked to take a different set of steps alternative to calling the customer service line.

Although you will still have the option to call in, because the resolution involves more research, we will not be able to resolve it immediately. Please see below for examples of this, with resolutions.

Alternatively, please use the Claim Denial Resolution tool or the Appeals Decision Tree.

Additionally, for denials where payment form is updated after the claim processes, please visit our Claims Payment alerts page for insight on how to have it pay correctly:

We apologize in advance for any inconvenience.

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