Full Answer
Does CGS determine who is eligible for Medicare?
We do not determine who is eligible for Medicare. CGS Administrators, LLC currently provides Part A Medicare claims processing and customer support services in the states of: Kentucky and Ohio.
What states does CCSG provide Medicare claims processing services?
CGS Administrators, LLC currently provides Part A Medicare claims processing and customer support services in the states of: Kentucky and Ohio.
What states does CGSS provide home health services?
CGS also provides services for Home Health and Hospice in the states of Colorado, Delaware, DC, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, South Dakota, Pennsylvania, Utah, Virginia, West Virginia, and Wyoming.
Where can I find information about Medicare fee-for-service providers?
For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) providers, including physicians, other practitioners and suppliers, go to the Provider Center (see under "Related Links" below).
Who owns CGS Medicare?
Celerian GroupCGS Administrators, a subsidiary of Celerian Group, is a Medicare Administrative Contractor (MAC) for the Centers for Medicare and Medicaid Services (CMS), the agency that oversees Medicare. Headquartered in Nashville, Tennessee, CGS serves 24 million Medicare beneficiaries and 100,000 health care professionals.
What does CGS mean in Medicare?
CGS Medicare stands for a Celerian Group Company. The company provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers.
Who is the Medicare contractor for Michigan?
WPS Government Health Administrators (WPS GHA) has served Medicare beneficiaries since 1966, providing over 50 years of service to the Centers for Medicare & Medicaid Services (CMS) and the Medicare program.
What is CGS Administrators LLC?
CGS Administrators, LLC provides a variety of services for Medicare beneficiaries, health care providers, and medical equipment suppliers in 38 states supporting the needs of over 24 million Medicare beneficiaries and 100,000 healthcare professionals nationwide.
Is national government services the same as Medicare?
National Government Services, Inc., a subsidiary of Anthem, Inc., has a long history of supporting federal health agencies, including the CMS . Throughout the country, NGS has served as a Medicare contractor since the inception of the Medicare Program over 56 years ago.
How do I bill for DME?
Billing for Durable medical equipment servicesVerify the Necessity of the Durable Medical Equipment. ... Credentialing. ... Make sure you have checked the patient's benefits and eligibility for the particular DME or Durable Medical Equipment. ... Make sure you understand the difference between billing out of network and in network.
What is the role of Medicare administrative contractors?
A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.
Which has been replaced with Medicare administrative contractors?
In 2003 the Centers for Medicare & Medicaid Services (CMS) was directed via Section 911 of the Medicare Prescription Drug Improvement, and Modernization Act (MMA) of 2003 to replace the Part A FIs and Part B carriers with A/B Medicare Administrative Contractors (MACs) in accordance with the Federal Acquisition ...
What does a Zone Program Integrity Contractor do?
Zone Program Integrity Contractors (“ZPICs”) are charged with the responsibility of investigating alleged instances of fraud, waste, or abuse by health care providers.
What states are in Medicare Jurisdiction C?
Jurisdiction C is serviced by CGS and includes Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia and the US Virgin Islands.
What is CGS insurance?
CGS is an administrative contractor for CMS. Consumers may never even know CGS is processing their claims. Since CGS is not an insurance provider, those seeking Medicare coverage should review Medicare health plans in their area. See our picks for the best Medicare Advantage plans in 2021. Learn More.
What is CGS claim?
CGS processes home health and hospice claims. Providers submit home health and hospice claims to the MAC covering the geography where the provider is physically located.
How many states does CGS cover?
CGS operates in 38 states plus three territories. Its footprint for some services overlaps. CGS is the DME MAC in Jurisdiction B (which includes seven states) and C (covering 15 states, Puerto Rico, and the Virgin Islands). CGS also serves as the home health and hospice MAC (in 15 states and the District of Columbia) and a Part A and B service provider in Ohio and Kentucky.
What is a CGS administrator?
CGS Administrators is a Medicare Administrative Contractor for Medicare. 1 It processes and pays claims for Medicare Parts A and B, durable medical equipment, and home health and hospice services in different parts of the country. Depending on where you live, CGS may be processing the claims your health care providers submit for your care and, ...
What does CGS do?
CGS processes claims for DME, orthotics, and prosthetics and provides service to the suppliers of those products. Suppliers submit claims to the MAC covering the geographic territory where the Medicare beneficiary lives.
How many states does Medicare operate in?
Extensive geography and services: Operates in 38 states and holds multiple Medicare Administrative Contracts (MAC).
What is the average compliance rate for CMS?
CMS evaluates MACs on dozens of compliance measures and publishes those results in overall reports by jurisdiction. Average compliance in Fiscal Year 2019 was 93% ; compliance in the jurisdictions CGS operates in was above 90%. 2 These CMS assessments provide oversight and accountability to the MACs.
How to get Medicare Advantage Plan?
You can obtain Medicare Advantage Plan (MAP) information through the myCGS web portal or through the Jurisdiction B IVR by calling 1.877.299.7900. To access MAP information in myCGS, log in to myCGS, and go to the Beneficiary Eligibility tab.
What is the phone number for CPAP?
For items which do not require a CMN/DIF (for example, CPAP supplies, as well as other items that are not capped rental or IRP items), contact Customer Support at 1.866.590.6727.
Does CGS provide corrections to K modifiers?
CGS does not provide corrections to "K" modifiers when they are billed incorrectly. These claims will deny with ANSI reason code 182, remark code N56. If you receive a denial due to either the incorrect billing of the "K" modifier or a missing narrative, you must correct the information and resubmit the claim.
What states does CGS administer Medicare?
CGS Administrators, LLC currently provides Part A Medicare claims processing and customer support services in the states of: Kentucky and Ohio. CGS also provides services for Home Health and Hospice in the states of Colorado, Delaware, DC, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, South Dakota, Pennsylvania, Utah, Virginia, West Virginia, and Wyoming. In addition we provide services for Medicare Part B for the states of: Ohio and Kentucky, and we provide service to Durable Medical Equipment suppliers in the states of: Alabama, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, West Virginia, and Wisconsin.
What is CGS administrator?
CGS Administrators, LLC provides a variety of services for Medicare beneficiaries, health care providers, and medical equipment suppliers in 38 states supporting the needs of over 24 million Medicare beneficiaries nationwide.
