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February 2, 2024

New Requirement When Calling the Provider Contact Center – Effective March 1, 2024

Claim- and eligibility-specific calls to the Provider Contact Center (PCC) must be authenticated through the Computer Telephone Integration (CTI) systemPDF. 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.

To protect the privacy of Medicare beneficiaries and providers, we must authenticate certain elements before releasing beneficiary-specific information. CTI allows you to securely enter beneficiary information before speaking to a Customer Service Representative (CSR).

You must authenticate the following elements:

  • 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.

We do not require authentication for general questions.

NOTE: The Interactive Voice Response (IVR) system and the myCGS Web Portal can answer most questions about a beneficiary’s Medicare eligibility and claim status. CSRs will transfer callers to the IVR for these types of questions.

Here are examples of Claim Specific and General questions:

Claim Specific Question General Question
  • Medicare eligibility information
  • Claim information (pending/processed)
  • Same or similar claim information
  • How to read a remittance advice
  • How to find information on the CGS or the CMS website
  • Questions about coverage (not related to a specific beneficiary)
  • Requesting a mailing address or telephone number

We first let you know about this change in November 2023, and we have included a reminder in our electronic mailing list every week. The effective date has been changed from February 1 to March 1. You can view the original notification here: New Authentication Requirement When Calling the Provider Contact Center


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