May 20, 2025
Save Time When Calling the Provider Contact Center
To protect the privacy of Medicare beneficiaries and providers, CGS authenticates certain elements before releasing beneficiary-specific information including:
- Provider National Provider Identifier (NPI),
- Provider Transaction Access Number (PTAN),
- The last five digits of the provider Tax Identification Number (TIN).
- Beneficiary’s Medicare Beneficiary Identifier,
- The first letter of the beneficiary’s first name,
- The first six letters of the beneficiary’s last name, and
- The beneficiary’s date of birth.
Callers must authenticate the above elements on their telephone keypad when using options 1, 4 and 5. PHI will not be taken verbally by the representative. Failure to authenticate the above elements will result in the caller not proceeding to a representative. Additionally, the caller will be transferred back to the beginning of the authentication process until disclosure requirements have been met.
Questions regarding claim status are to be answered through the Interactive Voice Response (IVR) system, myCGS and/or Direct Data Entry (DDE) for Part A and HHH providers. Please note, the Provider Contact Center (PCC) is to be referred to if the status of the claim has already been obtained from one of the previously mentioned options. If further details regarding the processing of the claim are required, that is when the PCC may assist. Eligibility information must be obtained through myCGS and DDE. For general information, please use option 9.
Additional Resources
- Medicare Beneficiary Identifier (MBI) and Name to Number Converter Tool
- Computer Telephony Integration (CTI) System
- Interactive Voice Response (IVR) system
- myCGS User Manual: Eligibility Section
- DDE User Manual: Beneficiary/CWF Option 10