CGS EDI Program

CGS EDI Program: Advantages and myCGS Portal

CGS EDI Program offers advantages to providers who conduct business with Medicare electronically. Some of those benefits include:

  • No more paper claims: EDI (submitting claims to CGS electronically eliminates paperwork so your staff can accomplish more in less time. You will also save money on postage and claim forms.
  • Earlier payment floor. Electronic claims may be paid as soon as 13 days after the date of submission, versus 29 days after the date of receipt for paper claims.
  • Earlier detection of errors. EDI edits ensure the validity of certain fields for electronic claims, which helps reduce reopening’s, claim adjustments and redeterminations (appeals).
  • Accurate payment – EDI reduces the possibility of manual entry errors, so your claims process more accurately and consistently.
  • Medicare claims submitted electronically may be accepted into processing system in as little as 24 hours.
  • Flexibility – With EDI, you control the frequency and volume of claims submission. You can also submit claims for several practitioners or facility locations at one time.
  • Electronic reports for better business management – Several reports are available only to electronic billers.
  • Support personnel – CGS EDI Help Desk staff are dedicated to supporting electronic claim submitters.
  • CGS provides information about electronic billing and offer support to all electronic billers in the testing and production process.

MyCGS Portal

MyCGS is a Web-based application in CGS EDI Program developed specifically to serve the needs of health care providers and their staff in Jurisdiction 15. Access to myCGS is available 24/7 and is free of charge. A wide range of information and features are available through myCGS, including:

  • Part B Claim Submission (Part B only)
  • Claim status
  • Remittances Advices
  • Beneficiary Eligibility
  • Financial Tools
  • Messaging/Letters
  • Forms – Redetermination Requests – Offset Request – Medical Review (MR) Additional Documentation Request (ADR) Responses – Part A Credit Balance Submission (Part A/HHH only) – Credit Balance Report.

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