February 26, 2015
myCGS: Submitting a Part B Medicare Secondary Payer (MSP) eClaim
The myCGS eClaim option allows all Medicare Part B providers to submit electronic claims via the web portal. This option is available to all providers, regardless of whether your office or practice currently submits Part B claims to CGS via Electronic Data Interchange (EDI), using PC-ACE Pro32 electronic filing software, or if you are still approved to file paper claims.
Medicare Secondary Payer (MSP) claims are also accepted through this option.
When the secondary option is selected, additional fields of the eClaim are displayed.
MSP claims require that the Patient Relationship to Insured and Insured Information fields be completed. Additional fields will display under the Miscellaneous Claim Information section.
Identify line items individually. MSP claims will display a field to enter the Primary Insurance Paid Amount and the Adjudication Date or Payment Date.
Reason / remark codes from the primary insurance explanation of benefits (EOB) are required in the Line Adjustments section. (Coincides with the CAS Segment of an electronic claim.) The Group Codes available are:
- CO (Contractual Obligation)
- OA (Other Adjustment)
- PR (Patient Responsibility)
Click Add Line Adjustments after entering each line item.
Select Edit to make changes or Delete to remove line items.
The Secondary Line Items section is to be completed identifying the services being submitted to CGS as secondary payer.
Once all line item details are entered, click the Add Line Information button. Do this for each line item. Select Edit to make changes or Delete to remove line items.
Enter the Payer Paid Amount. (The Total Charges field will auto-populate based on the line item charges entered on the claim.)
The primary insurance EOB is not required. Include any attachments needed to support allowing the service(s) submitted.
Submit the MSP eClaim when done.
For additional information regarding myCGS eClaims, please refer to Chapter 2: Claims Tab of the myCGS User Manual
|Two Vantage Way, Nashville, TN 37228||©2017 CGS Administrators, LLC. All Rights Reserved|