myCGS User Manual
Contents
1. myCGS User Manual N a iy QU JL O Claims Tab for Part B Providers C NJ Originated July 31 2012 C G S iced A 2014 A CELERIAN GROUP COMPANY 2014 Copyright CGS Administrators LLC CENTERS FOR MEDICARE amp MEDICAID SERVICES Claims Tab for Part B Providers CHAPTER 2 Table of Contents Claims Tab 3 Accessing Detailed Claim Information errereen 3 Viewing Detailed Claim Information sss 4 No Claims Data Appears sessssssssse eee 5 Claims Tab for Part B Providers 5 Submitting Claims sssssssss meme eee nee eren nnns 5 Claim Submission Summary Page and Confirmation Messages 6 Editing Claims 8 myCGS User Manual Page 2 GENE aR 2 Claims Tab for Part B Providers Claims Tab The Claims tab allows users to check the status of a beneficiary s claim which has been submitted to CGS Once you have signed into myCGS select the Claims tab by clicking on it Reminder Provider Administrators have access to all tabs within myCGS Provider Users only have access to those tabs granted by their Provider Administrator If you are a Provider User and the Claims tab is grayed out but you believe you need access to the Claims Tab you should contact your Provider Administrator The Claim Status Inquiry2. screen will appear Home Claim Remittance Eligibility Financial Tools Support Admin My Account Claim Inquiry To view daimit for a patient please enter the following informaton HIC Number m Date Range lax aX Accessing Claims Data To access claim status information you must enter the beneficiary s HIC Health Insurance Claim number also known as Medicare number You must also enter a date range ina MM DD CCYY format The date range will default to 45 days from the beginning date You can choose a shorter date range but you cannot choose a date range of more than 45 days Retrieving claims information older than 6 months may take additional time In addition offline claims will not be displayed Many claims are offline after 3 years sometimes earlier If there are claims in the date range you entered you will receive a list of claims found List of Claim Status Information XXXXXXXXXA Provider Number wy HIC Number Claim Status Information Claim Date of Service Bill Art Protest Date Check Claim Stak ark EXXRXXRKXMXXXX PO ES 2041 10 23 2041 708 amp n DS 0412 pee Completed SOCIO TO 23 2011 t0 23 2011 633 60 Oi i Complet aay CC CK TO z3 2011 10 23 2011 533 60 gu 24 13 OCC 10723 2011 PO 2500011 708 50 Caza tz AUC CPC ODDO CN 10 23 2011 1072372011 208 560 11 17 11 TO 23 2241 10 23 2341 633 40 11 17 11 Viewing Detailed Claim Information Each claim line will
3. decia pex refer ta the Auedicare Reenstbanc d He Once you have reviewed the detailed claim information you can either click Back to return to the claim list or click New Inquiry to submit a new claim status inquiry No Claims Data Appears If no claims are displayed for the date period you have chosen you may want to choose a different date range or double check your records to make sure you have entered the Information is retrieved from CMS standard systems and is as current as the standard systems Claims that are offline or returned without processing will not appear myCGS User Manual correct HIC number Claims that are paid in process returned or denied are displayed Page 4 CHAPTER 2 Claims Tab for Part B Providers Claims Tab for Part B Providers Part B users can access the electronic claim submission e Claim feature by accessing the Claim Submission sub tab located under the Claims tab If the Claim Submission sub tab is not displaying the user may not have access to this feature yet Submitting Claims Claim Submission Sub Tab Claims Claim Submission Rejected Claims is Medicare Primary Or Secondary Billing Provider Information Is your provider an organization or a solo practice Provider Contact Name Provider Address 1 Provider City Provider Zip Code Federal Tax LD Type 25H Ki Primary E Em EJ Provider Signature I
4. have a link to the claims details By clicking on the Claim link you can view the Detailed Claims Status Information screen myCGS User Manual Page 3 Claims Tab for Part B Providers CHAPTER 2 List of Claim Status Information XXXXXXXXXA Provider Number 30 HIC Number Claim Status Information Claims Date of Service Bill Amt Process Date Check Claim Statin POO T r234 2011 10 23 2011 708 40 C4 Ga tt no Congelad TOO TO 23 2241 30 23 2011 DOES 10 23 2011 1062312011 10 23 2011 TOrz3 2011 T0 23 2011 10 23 2011 10 23 2011 433 50 533 80 708 60 535 40 ter iz asta ts Orga iz 11717711 1117711 Computed Compete The Detailed Claims Status Information screen provides detailed information for each claim line including e Revenue codes e Service date e Allowed amount e HCPCS codes Non covered charges Total charge List of Claim Status Information XXKXXXXXXXA Provider Number HIC Number 3ODDODODCOCA Detailed Claim Status Information Claim XXXXXXXXXXXXXX Date of Serie ES Amt Claim Siabus Corie Carel Bee Ded Pak The 10 23 2011 20 4 ZX 2011 7JOB 8 Completed 0 00 hoo 0 00 0 00 Linee Sur Dabes Total Allowed Amur Hon Covered Denial Text 1 TOr23 2011 525 00 0 00 525 00 To obtain the r reason for 10 23 2011 denial peace refer be ihg Mam arg Beesttas hah aoe 10 23 2011 18553 To obtain the s reason for 10 23 2011
5. each to each claim The attachments must be in PDF format and created using appropriate PDF creation software Failure to create the PDF correctly can result in a corrupt file that could prevent you from successfully submitting the e Claim Claim Submission Summary Page and Confirmation Messages Once you successfully submit the eClaim form you will be directed to a Claim Submission Summary page that will provide the myCGS Transaction ID for this e Claim submission The myCGS transaction ID will serve as a confirmation number for the e Claim submission until the submission is accepted and an Internal Control Number ICN is assigned Rejected claims will not receive an ICN Claim Submission Summary CGS Transaction ID 20047 HICN NNHNNNNHNNN Patient s Name John Doe Provider MPI NNNNHNNHNNN Date Of Service DOS Primary Date From Primary Date To Secondary Date From Secondary Date To 07 07 2014 07 07 2014 myCGS User Manual Page 6 Claims Tab for Part B Providers CHAPTER 2 You will receive messages regarding your e Claim submissions in your myCGS inbox Access the Messages tab to read these The first message is the Submission Confirmation This message confirms that the e Claim form was sent A second message will be available once the e Claim submission is accepted or rejected This may take 24 48 hours not including weekends or holidays to receive If the submission is accepted an ICN and DCN if attachm
6. ents are submitted will be provided in the message Note Receiving an accepted message does not mean that the claim is approved to be paid and does not constitute approval or a determination of medical necessity It simply means your claim has been accepted into the claims processing system Once the claim has been processed the approval or denial information will be on your remittance advice A rejected message will include the corresponding error messages informing the user what to correct If you need to contact CGS regarding questions about a rejected claim be prepared to provide the file name listed in the rejected inbox message Any e Claim submissions that were rejected will display on the Rejected Claims sub tab From the Rejected Claims sub tab you can correct rejected e Claims and resubmit them through myCGS This is considered a separate claim submission so any required attachments will need to be resubmitted A new transaction ID will also be assigned Messages Tab You have 8 unread message s and O alerts Go To Page Select Form MESSAGE INBOX ARCHIVED MESSAGES Click on the subject links to view messages Bold links indicate new unread messages Delete Selected In message inbox Displaying 1 8 of 29 First Prev 1 7 3 4 Next Last L Partim Fri Sep 26 1457 EDT 2014 Secure Claim Submision Confinmation 3 4d2615A Ho Submission ID O Part Claims Thu epi5 17 42 EDT 2014 Secure Claim S
7. ndicator Yes G H Accept Assignment Yes ie No kd Organization LJ Hover your mouse over each field seconda OL Click the question mark icon to view tips for completing each field Solo Practice LJ Provider Addres Provider State a v Provider HPI NANA Federal Tax 1 0 Number Before you begin Gather the same information you would need prior to submitting a claim through PC ACE Pro32 paper CMS 1500 claim form or to transmit to your vendor You will enter detailed information that corresponds with CMS s claim submission requirements Use the Add Line icon below the Narrative field to enter additional lines services myCGS User Manual Page 5 Claims Tab for Part B Providers CHAPTER 2 Line Items Primary Line Items Date From Procedure Code Place Of Service amp m Procedure Modifer 1 Procedure Modifer 3 Description Diagnosis Pointer 1 e I Diagnosis Pointer 3 L w Days or Units of Service OR Anesthesia Minutes Marralive Add Line Informatipn Add Line The e Claim form is dynamic so the fields that display will vary based on the data that is entered on the form All required fields are marked with a red asterisk There are also tool tips that will display as you hover on the field or question mark icon to help you determine how to complete the field You may attach up to five PDF files up to 5 MB in size
8. ubmizrion Receipt 28 AD92b6 WHS202 1426500007 CI Parte claim Thu Sep 25 17 32 EDT 2014 Secure Claim Submission Receipt 02 840926 WI 5202 1426900001 Part 8 Claims Thu Sep 25 17 27 EDT 2014 Secure Claim Submission Confirmation 28 4092t4 No Submission ID L1 Part 6 Clade Tha5ep2517 Z22EDT 2014 Secure Claim Sgbmizrion Receipt 3 4 26354 No Submission ID Cl Parte ctaims ThuSep25 17 19 EDT 2014 Secure Claim Submission Confirmation 02 84002b No Submission ID Part B Claims Thu Sep 25 17 12 EDT 2014 Secure Claim Submission Receipt 02 84092b No Submission ID C Part 8 Claim Thusep25 17 05 EDT 2014 re Claim Sutemissior mation 00 4295 No Submission ID Disclaimer About Us Contact Us Help Sibe Map eiii Eg F 54 Jd Bd minmirmkur Tan run LN robe Secure Claim Submission Confirmation will appear once claim is submitted Secure Claim Submission Receipt will appear when claim is accepted or rejected Rejected claims will have no Submission ID myCGS User Manual Page f Claims Tab for Part B Providers CHAPTER 2 Editing Claims Click on the Edit icon to edit your claims and a new screen will appear You must view this line and select Edit or Delete Editing Lines Add Line infomation Count Procedure Modifier 1 H Actions Date From Place Of Service Procedure Code M E 1 Edit Delero 05 05 2014 06 05 2014 myCGS User Manual Page 8
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