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Claims Tab (for Part B Providers)
myCGSUser Manual
CH
AP
TE
R 2
Originated July 31, 2012Revised June 3, 2015
2015 Copyright, CGS Administrators, LLC.
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Claims Tab (for Part B Providers)
myCGS User Manual
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Table of Contents
Claims Tab 3
Accessing Detailed Claim Information 3
Viewing Detailed Claim Information 4
No Claims Data Appears 4
Submitting Part B Claims (eClaims) 5
Accessing the myCGS eClaim Form 5
Completing the myCGS eClaim Form 5
Billing Provider Information Section 5
Patient Information Section 6
Miscellaneous Claim Information Section 7
Diagnosis Information Section 7
Line Item Section 8
Attachments Section 10
Submitting Specialty Claims 11
Completing Primary eClaim with Medicap/Crossover 14
Medicare Secondary Payer (MSP) eClaims 15
eClaim Submission Summary 19
Messages Tab 19
Rejected Claims 20
DISCLAIMERThis educational resource was prepared to assist
Medicare providers and is not intended to grant rights or impose
obligations. CGS makes no representation, warranty, or guarantee
that this compilation of Medicare information is error-free, and
will bear no responsibility or liability for the results or
consequences of the use of these materials. CGS encourages users to
review the specific statutes, regulations and other interpretive
materials for a full and accurate statement of their contents.
Although this material is not copyrighted, the Centers for Medicare
& Medicaid Services (CMS) prohibit reproduction for profit
making purposes.
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Claims Tab
The Claims tab allows users to check the status of a
beneficiarys 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 Inquiry screen will appear.
Accessing Claims Data
To access claim status information, you must enter the
beneficiarys HIC (Health Insurance Claim) number, also known as
Medicare number. You must also enter a date range in a 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.
Viewing Detailed Claim Information
Each claim line will have a link to the claims details. By
clicking on the Claim # link, you can view the Detailed Claims
Status Information screen.
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The Detailed Claims Status Information screen provides detailed
information for each claim line, including:
Revenue codes HCPCS codes
Service date Total charge
Allowed amount Non-covered charges
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 correct HIC number.
Claims that are paid, in process, returned, or denied are
displayed. 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.
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Submitting Part B Claims (eClaims)
Part B users can access the electronic claim submission (eClaim)
option within myCGS. In addition, users may submit additional
supporting documentation, monitor the status of the submission and
make corrections to eClaims failing our front-end edits.
Before you begin, gather the same information you would need
prior to submitting a claim through PC-ACE Pro32, a
commercially-available billing software or a paper CMS-1500 claim
form. You will enter detailed information that corresponds with
CMSs claim submission requirements.
Accessing the myCGS eClaim Form
The eClaims form is available under the Claim Submission sub-tab
located under the Claims tab. If the Claim Submission sub-tab is
not displaying, the user may not have been granted access to this
feature by the office Provider Administrator.
Completing the myCGS eClaim Form
Identify whether Medicare is the primary or secondary payer for
the claim being submitted. Also identify if the patient is signed
up for Medigap or crossover.
NOTE: If you select an option in error and need to change it,
simply click the Claim Submission sub-tab again or the Clear button
located at the bottom of the form and start over.
Billing Provider Information Section
You must complete the following fields to submit your
eClaim:
Organization or Solo Practice option: Entities such as Ambulance
suppliers need to select Solo Practice and enter the Organization
Name
Provider Organization Name
Provider Last Name/First Name: This section will display only
when Solo Practice is selected but only required by solo practice
physicians/practitioners
Provider Contact Name and Phone Number: Required should we need
to speak with someone regarding the eClaim, i.e., office
manager
Complete Address: Street address and ZIP code + 4 are required.
No PO Boxes are accepted
Federal Tax ID Type and Number
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Provider Signature Indicator
Accept Assignment
Patient Information Section
You must complete the following fields:
Patient Medicare Number
Patient Account Number
Patient Last Name/First Name
Patient Date of Birth
Patient Sex
Patients Complete Address: Including ZIP+4
Patient Signature Indicator: If you have patient authorization
to submit the claim to CGS, select the P indicator in the dropdown
box
Release of Information
Benefits Assignment Certification
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Miscellaneous Claim Information Section
This section is not required but may apply in certain
situations. If you have a referring provider to report; CLIA number
for clinical lab services; facility information; homebound
indicators; the date care was assumed/relinquished for split
post-op care; if you enter this information when submitting claims
by other means, you will need to enter the information on an
eClaim.
Diagnosis Information Section
Enter at least ONE diagnosis code. List the primary diagnosis in
the Diagnosis A field. Up to 12 diagnoses may be entered on the
form.
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. Line Item Section
This section is where you enter the line item details.
Date of Service
CPT/HCPCS Code
Place of Service
Description (if needed)
Diagnosis Pointer (at least one)
Days or Units
Charge
Rendering Provider: Complete this area when Organization is
selected at the top of the form
Enter line items one at a time. After entering all applicable
information, click the Add Line Information button.
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After entering all line item information for the claim, verify
the information entered is correct. Use the sliding scroll bar to
view the line item details. If you find charges are needed, select
the Edit link and the section will re-populate with the line item
details to allow you to make the necessary changes. If you want to
delete the line item altogether, simply select the Delete link.
When you are finished with editing, select the Save Line
Information button.
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Attachments Section
Additional required fields are located at the bottom of the
form.
Submitter Name: Enter the name of the person authorized to
submit the eClaim on behalf of the provider. This will serve as an
electronic signature.
Total Charges: This field is auto-populated based on the line
item charges entered above.
If you are submitting a service you know requires additional
documentation such as an operative or radiology report, you can
attach it to the eClaim.
An eClaim can include up to 5 documents. Each being up to 5MB in
size and in a PDF format. If you maintain paper records, you can
scan the document you want to attach to the eClaim and save it as a
PDF.
Click Submit to file the eClaim.
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Submitting Specialty Claims
myCGS eClaims are available for various types of services
rendered by various specialties.
Ambulance suppliers will find the eClaim will populate with
details required with an ambulance claim, such as point of pick-up
fields and an area to enter condition codes. The eClaim will
display these fields when the ambulance place of service code is
selected.
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Chiropractors will have access to different fields when one of
the chiropractic CPT codes are entered on the form. Fields for
x-ray date and for you to identify whether the patients condition
is acute or chronic will be available to you.
For providers submitting claims for Erythropoietin for the
treatment of anemia for patients with chronic renal failure who are
on dialysis, entering the HCPCS code will display a field to note
the patients hematocrit or hemoglobin levels.
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Submitting Mammography services will display a field for the
certification number.
Submitting a Not Otherwise Classified (NOC) drug code will
display a field to enter the NDC number. Other NOC codes will
require the Description field to be completed.
Podiatry services submitted will allow users to enter the date
the patient was last seen by their MD, DO or qualified
non-physician practitioner who diagnosed the condition.
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A Date Last Seen field will display when physical therapy
services are submitted.
The myCGS eClaim will accept the non-payable quality measures
associated with the Physician Quality Reporting System, or PQRS, as
well.
Completing Primary eClaim with Medigap/Crossover
eClaims may be submitted if the patient has a medigap or
crossover insurer.
Selecting the Medigap/Crossover option will display additional
fields to be completed. A Patient Relationship to Insured field and
Insured Information section located further down must be
completed.
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Medicare Secondary Payer (MSP) eClaims
eClaims may also be submitted when Medicare is the secondary
payer.
When Secondary is selected, the form will display a Patient
Relationship to Insured field and Insured Information section
located further down.
Under Miscellaneous Claim Information, additional fields will
display.
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Under Line Items, additional fields will display. 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)
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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.
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Enter the Primary Paid Amount in the appropriate field. The
primary insurance EOB is NOT required. Include any attachments
needed to support allowing the service(s) submitted.
Click Submit to file the MSP eClaim.
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myCGS User Manual
CHAPTER 2
Page 19Orig
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only
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Am
eric
an M
edic
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n. A
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PT
is a
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trad
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the
Am
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pp
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20
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LLC
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eClaim Submission Summary
After submitting the eClaim, the Claim Submission Summary page
will display. It is confirmation the eClaim was received. The
summary page includes a CGS Transaction ID and other details from
the claim.
Messages Tab
After submitting the eClaim, you will receive a secure message
confirming it was sent. Within 24-48hrs (excluding weekends and
holidays), a second secure message will be sent confirming eClaim
was accepted or rejected.
If accepted, a Submission ID (ICN or DCN) will be assigned to
the eClaim.
-
Claims Tab (for Part B Providers)
myCGS User Manual
CHAPTER 2
Page 20Orig
inat
ed J
uly
31,
20
12
Rev
ised
Jun
e 3
, 20
15. C
PT
only
cop
yrig
ht 2
015
Am
eric
an M
edic
al A
ssoc
iatio
n. A
ll ri
ght
s re
serv
ed. C
PT
is a
reg
iste
red
trad
emar
k of
the
Am
eric
an M
edic
al A
ssoc
iatio
n. A
pp
licab
le F
AR
S\D
FAR
S R
estr
ictio
ns A
pp
ly t
o G
over
nmen
t U
se.
20
1 C
opyr
ight
, CG
S A
dm
inis
trat
ors,
LLC
.
The Submission ID can be used to check the status of the eClaim.
Check the remittance advice for approval or denial information.
Rejected Claims
Electronic claims must pass Front End Edits prior to entering
our processing system. These edits verify all required information
is on the claim. Claims submitted through myCGS are subject to the
same editing process.
Claims failing these edits are rejected and an ICN/ DCN is not
assigned. Check the Rejected Claims sub-tab. Click on Edit to make
corrections to the claim.
The details of the rejected claim will display identifying Error
Data at the top of the form. Fields that failed an edit will be
displayed.
http://
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Claims Tab (for Part B Providers)
myCGS User Manual
CHAPTER 2
Page 21Orig
inat
ed J
uly
31,
20
12
Rev
ised
Jun
e 3
, 20
15. C
PT
only
cop
yrig
ht 2
015
Am
eric
an M
edic
al A
ssoc
iatio
n. A
ll ri
ght
s re
serv
ed. C
PT
is a
reg
iste
red
trad
emar
k of
the
Am
eric
an M
edic
al A
ssoc
iatio
n. A
pp
licab
le F
AR
S\D
FAR
S R
estr
ictio
ns A
pp
ly t
o G
over
nmen
t U
se.
20
1 C
opyr
ight
, CG
S A
dm
inis
trat
ors,
LLC
.
Scroll down and make the necessary corrections to identified
fields of the eClaim. After making ALL corrections, click Submit to
resend the eClaim to CGS.
NOTE: Documentation attached to the original claim MUST be
re-attached after making corrections to rejected claims. Also,
making corrections to rejected claims is limited to those submitted
through myCGS.
Claims Tab Accessing Claims DataViewing Detailed Claim
InformationNo Claims Data Appears Accessing the myCGS eClaim Form
Completing the myCGS eClaim Form Billing Provider Information
Section Patient Information Section Miscellaneous Claim Information
Section Diagnosis Information Section Line Item Section
Attachments Section Completing Primary eClaim with
Medigap/CrossoverMedicare Secondary Payer (MSP) eClaims eClaim
Submission Summary Messages Tab Rejected Claims
