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myCGS User Manual Chapter 1

Chapter 1 – myCGS Overview

What is myCGS?

The myCGS portal is a web-based application developed by CGS that is available to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) who serve beneficiaries in Jurisdictions B and C. Using myCGS is a fast and easy way to get Medicare claim and billing information.

myCGS offers suppliers a wide range of functionality and support, such as:

  • Beneficiary Eligibility
    Find beneficiary eligibility, Medicare Secondary Payer, Medicare Advantage Plan, home health episode, hospice, and inpatient stay information.
  • Claim Status
    Check on the status of claims you've submitted to Jurisdiction B or C
  • Same or Similar Information
    Search beneficiary claim history for same or similar items
  • Redetermination and Reopening Status and Submission
    Check the status of your Redetermination and Reopening requests and submit new requests directly through myCGS
  • ADMC and Prior Authorization Status and Submission
    Submit ADMC and Prior Authorization requests and check their status directly through myCGS
  • Claim Corrections
    Make corrections to claims that have been processed by CGS
  • And More!

This manual contains the information you need to navigate myCGS and take advantage of its many helpful features. The instructions in this manual assume that you are familiar with basic Medicare rules and regulations as they pertain to DMEPOS suppliers. For a detailed overview of Medicare DMEPOS rules and regulations, refer to our Supplier Manual. The Supplier Manual is the first resource that you should use for Medicare billing questions. You can access the Supplier Manual at the links below (depending on your jurisdiction).

DME MAC Jurisdiction B Supplier Manual

DME MAC Jurisdiction C Supplier Manual

For instructions on myCGS registration and user maintenance, refer to the myCGS Registration & Account Management Guide. For news and updates regarding myCGS, as well as other important DME MAC articles and information, be sure to subscribe to our ListServ, the CGS electronic mailing list.

If you have any questions that cannot be answered in this manual or the Supplier Manual, contact our Customer Service Department at one of the following phone numbers (be sure to call the correct jurisdiction ):

Jurisdiction B: 1.866.590.6727

Jurisdiction C: 1.866.270.4909

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Who Can Use myCGS?

Any DMEPOS supplier or affiliate who serves beneficiaries in Jurisdictions B and/or C may register for myCGS. Jurisdiction A and D suppliers may also register for myCGS using the Same/Similar User role. All myCGS users must be approved through the myCGS registration process before receiving the ability to use myCGS. For assistance with registering for myCGS, refer to the myCGS Registration Guide.

There are four different types of myCGS user roles—End User, Designated Approver, Clearinghouse/Billing Agent (CHBA), and Same/Similar User (SSU). The majority of the functionality within myCGS is available to all user roles, except for the SSU role (which is limited to the Same/Similar tool only). The additional feature of being able to maintain user privileges is available only to Designated Approvers.

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Logging in to myCGS

Before you can use myCGS, you must complete the registration process and receive a myCGS User ID and password. Refer to the myCGS Registration Guide for instructions on how to register.

Once you have successfully registered, follow these steps to log in to myCGS:

  1. Open myCGS by going to https://mycgsportal.com.
  2. Select the Log in to DME myCGS link.
  3. Log in using your myCGS User ID and Password.

    NOTE: Your account will be locked if you enter your password incorrectly three consecutive times within a 120-minute period. Once your account is locked, you must call our Provider Contact Center to have your account unlocked.

  4. Generate a Multi-Factor Authentication (MFA) code. To generate an MFA code, press the appropriate button (or letter on your keyboard—T, E, or B) for how you would like to receive the code—Text, Email, or Both, or if you have Google Authenticator set up, simply enter your Google Authenticator code. Once you have received the MFA code, enter the code and press Next.

    NOTE: Text and email MFA codes are valid for up to 12 hours after they are initially generated and can be reused throughout the entire 12-hour window. Note that if you request another MFA code, only the most recently generated code is valid.

  5. Read the myCGS Terms and Conditions, and then select your DME Jurisdiction (B or C).

    NOTE: You can easily switch back and forth between Jurisdictions B and C without having to log out of myCGS. Refer to the Switching between Jurisdictions section below.

  6. Once you have successfully logged in, you will be taken to the myCGS Home screen.

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Once logged in (as an End User or CHBA), you will see nine menu selections across the top of the myCGS portal—Home, Beneficiary Information, Same/Similar, Claims, Claim Preparation, Finance, Reprocessing, MBI Lookup, and News & Information. To get started, select the menu that contains the information you need. In this manual, you will find a section devoted to each of these menu screens.

NOTE: If you are registered for myCGS as a Designated Approver, then you will be taken directly to the User Management section of myCGS when you first log in. Press the Home menu to go to the End User section. Refer to the Admin section in this manual for additional information. If you are registered as an SSU, you will only see three menu selections: Home, Same/Similar, and News & Information.

If one or more of your menu options has a locked icon, then you do not have permission to view/use that menu. Request access to any locked menus from your Designated Approver. You will not be able to access a locked menu until your Designated Approver updates your user permissions. Refer to the Locked Menus section below.

NOTE: Be sure to log in regularly and to keep your password up to date. If you do not log in for 30 consecutive days, your account will be suspended—in order to reactivate your account, you must call our Provider Contact Center. If you do not log in for 90 consecutive days, your account will be deactivated, and you will need to re-register for myCGS. In order to qualify as an active login, you must successfully complete the entire myCGS login process, including use of your MFA code.

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myCGS Interface Overview

myCGS contains eight primary menu options, as well as account, help, and feedback sections. Use the sections throughout this manual to find detailed information about all of the myCGS functions and capabilities.

The image below shows the main areas of myCGS:

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Switching between Jurisdictions

If you are a supplier who services beneficiaries in both Jurisdictions B and C, myCGS allows you to easily switch back and forth between the two jurisdictions. To do so, simply press the appropriate jurisdiction button in the top-center of your screen.

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You can always know which jurisdiction you are currently viewing based on the color scheme of myCGS, as well as the JB or JC label in the top-right corner of the main body of myCGS. As you can see in the screen images below, yellow is Jurisdiction B, and green is Jurisdiction C.

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Change NPI/PTAN

Most of the functional capabilities in myCGS depend on your supplier information—your NPI and PTAN. If you represent a company that uses only one NPI/PTAN, then you do not need to worry about changing NPI/PTANs—your correct NPI/PTAN information will always populate automatically in any screen that requires supplier information in myCGS. But if you represent a company that has multiple NPI/PTAN combinations, then you need to make sure you are using the appropriate NPI/PTAN for the information you are requesting.

NOTE: myCGS will automatically give you access to all of the NPI/PTAN combinations that are associated with your Tax ID.

Switching between NPI/PTANs in myCGS is easy. In the upper-right corner of myCGS, you will always see the NPI/PTAN associated with your account that is currently selected. This NPI/PTAN will auto-populate in any functional screen within myCGS that requires supplier information.

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To change to a different NPI/PTAN, use the dropdown arrow found in the "Select Jurisdiction" box---a dropdown menu will appear that allows you to switch to a different NPI/PTAN.

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If you have a large number of NPI/PTAN combinations, you can enter the first few digits of your desired NPI to narrow down your search and easily find the NPI/PTAN you need.

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Default NPI/PTAN

If you are an End User or Designated Approver and have more than one NPI/PTAN, then you may wish to set a default NPI/PTAN so that myCGS always opens with your default selected. When you log in to myCGS, your currently selected NPI/PTAN will be random unless you’ve selected a default. myCGS allows you to set a default NPI/PTAN for both Jurisdiction B and C. Note that only End Users and Designated Approvers are able to set a default NPI/PTAN.

You can tell if the NPI/PTAN that is currently selected is your default based on the color of the checkmark icon found in the upper-right corner of the screen next to your NPI/PTAN.

  • If the icon is gray, then the NPI/PTAN is not your default.
  • If the icon is blue, then the NPI/PTAN is your default.

There are two ways to set a default NPI/PTAN in myCGS:

  • Use the View NPI/PTAN screen found in the My Account menu.
  • Use the checkmark icon, which functions as a toggle switch.

For instructions on using the View NPI/PTAN screen to set a default NPI/PTAN, refer to Chapter 11 of this manual.

To set a default NPI/PTAN using the checkmark icon toggle, follow these steps:

  • Select the NPI/PTAN you wish to use as your default from the dropdown menu in the Select Jurisdiction section of your dashboard (refer to the Change NPI/PTAN section in this chapter). The NPI/PTAN you select will then be displayed on the right side of your dashboard.
  • Click on the gray checkmark icon next to your NPI/PTAN. This will set your currently selected NPI/PTAN as default for the jurisdiction you are currently using. The checkmark will turn blue, indicating that this NPI/PTAN is now your default in the jurisdiction. Repeat these steps to set a default NPI/PTAN in the other jurisdiction (B or C).

NOTE: Setting a default NPI/PTAN in Jurisdiction B does not affect your default in Jurisdiction C, and vice versa. Each jurisdiction default works independently. You can choose to have a default in one jurisdiction, but not set a default in the other. You can select the same default NPI/PTAN in both jurisdictions. You can also select different default NPI/PTANs for each jurisdiction.

Note that the checkmark icon functions as a toggle. Clicking on a gray checkmark icon will set your current NPI/PTAN as default. Clicking on a blue checkmark will remove the default.

The following image shows a gray checkmark icon, indicating that NPI/PTAN currently selected is not the default NPI/PTAN:

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This image shows a blue checkmark icon, meaning that the current NPI/PTAN is set as the default:

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Medicare ID

All transactions in myCGS should be completed using the Medicare Beneficiary Identifier (MBI) as the beneficiary's Medicare ID, with limited exceptions. All search screens in myCGS either default to the MBI or are MBI-only.

There are rare occasions in which you may still need to use a Health Insurance Claim Number (HICN) in myCGS. For any screen that allows either MBI or HICN, the default value of the Medicare ID field is MBI. If you need to search by HICN, enter the HICN in the Medicare ID field and then select the HICN radio button.

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Locked Menus

Your organization's Designated Approver has the ability to grant or take away user permissions specific to your user profile. These permissions control which features you can and cannot use in myCGS. If one of your function menus shows a closed lock icon, then you do not have permission to use this function and will not be able to access the menu.

NOTE: If you are a CHBA user, your permissions have been set by the DMEPOS supplier in their CEDI authorization agreement.

If you need access to a menu which is currently locked, contact your Designated Approver and request access.

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