Rejected Claims
Electronic claims must pass front-end edits prior to entering our processing system. myCGS claims are subject to this same editing. Claims submitted through myCGS that fail these edits are rejected. You may access the rejected claim, make the necessary corrections, and release it to be processed.
- Check for rejected claims by selecting the "Rejected Claims"sub-tab.
- Select the "Edit"link located in the last column of the claim line.
- The details of the rejection will display.
- Scroll down to make the corrections needed and click "Submit"to resend the claim.
- This is considered a new submission, so if documentation was attached to the original claim, you must re-attach the same documents to this submission. A new Transaction ID will be assigned to the claim.
NOTE: The CGS Advance Communication Engine (ACE) Smart Edits are also a part of the pre-adjudication process.