cgs jurisdiction 15 part b interactive voice response (ivr...
TRANSCRIPT
NOTE: For assistance with entering the MBI and the beneficiary’s name, refer to the following self-service options:
Part B Medicare Beneficiary Identifier (MBI) Converter at: https://www.cgsmedicare.com/medicare_dynamic/j15/mbiconverter_j15b.asp
IVR Beneficiary Name to Number Converter at: https://www.cgsmedicare.com/medicare_dynamic/j15/converter.asp
CGS Jurisdiction 15 Part B Interactive Voice Response (IVR) System
Available:
1. Addresses
2. Phone numbers
3. Appeal information
4. Provider Outreach & Education information
5. Hot Topics
6. Provider Enrollment information
General Information
Available:
• Claim payment
• Claim denial
• Denial reason by line
• Duplicate remit for a claim
• Claim number
• Redetermination status
Claim & Redetermination Status
Enter HICN or MBI, beneficiary name, and
date of service.
Available:
1. Part A/B Eligibility
1. Medicare Advantage Plan information
1. MSP information
1. Home Health & Hospice
2. Amount of a deductible applied for the current and one previous calendar year.
3. Physical Therapy limitation applied for the current calendar year (when applicable).
4. Occupational Therapy limitation applied for the current calendar year (when applicable).
Beneficiary Eligibility, Deductible, & Therapy
Limitations
Enter HICN or MBI, beneficiary name, and
date of service.
Available:
1. Oustanding check information.
1. EFTs issued over the previous seven days.
2. Total claims in approved to pay and waiting payment floor.
3. Total pending claims.
4. Offset information.
Financial Information
Enter provider information.
Available:
1. Allowable information
2. Order a duplicate remit by date.
Other Information
Enter provider information.
Available:
• Verify the NPI and PTAN combination on the crosswalk.
• Verify individual NPI is in PECOS.
NPI/PTAN Crosswalk
Enter provider information.
Enter PTAN Letters:
A. 21 D. 31 G. 41 J. 51 M. 61 P. 71 S. 73 V. 83 Y. 93
B. 22 E. 32 H. 42 K. 52 N. 62 Q. 11 T. 81 W. 91 Z. 12
C. 23 F. 33 I. 43 L. 53 O. 63 R. 72 U. 82 X. 92
The IVR is available 24 hours a day, 7 days a week for General Information (menu option 6).
Monday - Friday: 7:00 a.m. to 7:00 p.m. ET for all other information.USER GUIDE
Standard Functions: 7 = Repeat 8 = Main Menu 9 = NPI/PTAN
Part B IVR Number: 1.866.290.4036
INFORMATION YOU MAY NEED:
Revised March 28, 2018. © 2018 Copyright, CGS Administrators, LLC.
• NPI• PTAN• Last five digits of tax identification
number (effective 04.06.2009)
• MBI (Medicare beneficiary identifier) OR HICN (health insurance claim number) - Press “1” for MBI - Press “2” for HICN
• Beneficiary’s first initial• Beneficiary’s last name -
Enter up to six letters followed by “#” sign (ignore any spaces)
• Beneficiary date of birth• Date of service(s)• HCPCS code/modifiers