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How do I access eligibility information for a Medicare patient?

Providers are required to use self-service technology, such as the Interactive Voice Response (IVR) system or the myCGS web portal to access claim status and beneficiary eligibility information. Customer Service Representatives (CSRs) will refer providers to these resources when calling for claims status or eligibility information. Exceptions will be made if your experience technical difficulties.

Interactive Voice Response (IVR) – Use the IVR to check the eligibility of a Medicare beneficiary by calling 1.866.290.4036 and select Option 2. Refer to the CGS J15 Part B IVR User GuidePDF for additional information. Use the Medicare Beneficiary Identifier (MBI) and Name to Number Converter self-service option. This tool converts letters to numbers for easy entry using your telephone keypad.

myCGS Web Portal – myCGS also provides eligibility information. Refer to the myCGS User Manual, Eligibility Tab for detailed instructions. If you are not registered to access myCGS, refer to the myCGS Introduction Tab for additional information.

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