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EDI

Electronic Data Interchange (EDI)

CGS encourages providers to conduct business with Medicare electronically. Benefits of electronic submission include:

  • No more paper claims. EDI (submitting claims to CGS electronically eliminates paperwork so your staff can accomplish more in less time. You will also save money on postage and claim forms.
  • Earlier payment floor. Electronic claims may be paid as soon as 13 days after the date of submission, versus 29 days after the date of receipt for paper claims.
  • Earlier detection of errors. EDI edits ensure the validity of certain fields for electronic claims, which helps reduce reopenings, claim adjustments and redeterminations (appeals).
  • Accurate payment. EDI reduces the possibility of manual entry errors, so your claims process more accurately and consistently.
  • Fast Acceptance. Medicare claims submitted electronically may be accepted into out processing system in as little as 24 hours.
  • Flexibility With EDI, you control the frequency and volume of claims submission. You can also submit claims for several practitioners or facility locations at one time.
  • Electronic reports for better business management Several reports are available only to electronic billers.
  • Support personnel CGS EDI Help Desk staff are dedicated to supporting electronic claim submitters. We provide information about electronic billing and offer support to all electronic billers in the testing and production process.
    • EDI Help Desk staff is available Monday through Friday 8:00 a.m. to 5:00 p.m. E.T.
    • Ohio/Kentucky Part B 1.866-276.9558, option 2
    • Ohio/Kentucky Part A 1.866-590.6703, option 2
    • Home Health/Hospice 1.877.299.4500, option 2

myCGS Portal

myCGS is a web-based application developed specifically to serve the needs of health care providers and their staff in Jurisdiction 15. Access to myCGS is available 24/7,and is free of charge to all CGS providers. myCGS offers a variety of functions, such as, access to beneficiary eligibility, claim and payment information, forms allowing you to submit redetermination requests, and respond to Medical Review Additional Development Requests (ADR), and much more. Refer to the myCGS User Manual Web page for more details.

To use myCGS, providers must have an Electronic Data Interchange (EDI) agreement on file with CGS. If you do not have an EDI agreement with CGS, refer to the J15 EDI Enrollment (Agreement) Form & InstructionsPDF document for assistance. In addition, to ensure you are able to utilize this free self-service option, please refer to the myCGS System Requirements.

EDI Enrollment

EDI Enrollment

Status Checker

Status Checker

277CA Edit Lookup Tool

277CA Edit Lookup Tool

PC Print

PC Print

User Guides

User Guides

PC-Ace Pro32 Software

PC-Ace Pro32 Software

 

Top Provider Questions – EDI

Top Provider Questions – EDI

 

Updated: 11.24.21

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