News Tags: MAC J15 Ohio
The Reopening’s process allows you to request corrections to minor errors or omissions on previously processed claims through myCGS, over the phone or in writing. Requests to add or remove HCPCS modifiers CT, FX, or GY cannot be handled over the phone, as they may require additional documentation and/or result in an overpayment. CT — Computed... more
CGS released the third form in the series - The Billed Amount, Procedure Code, and Both Combined Adjustment Request Form. Check here for a link to the new form and step-by-step instructions to help you add or replace a billed amount, a procedure code, or a combined billed amount and procedure code on a previously processed claim.
CGS released the second form in the series - The Reopenings Date of Service Adjustment Request Form. Check here for a link to the new form and step-by-step instructions to help you request simple corrections specific to updating the date of service on a previously processed claim.
In the comings months, CGS will introduce a number of new forms to request specific types of Reopenings. This process improvement will help facilitate their efforts to automate Reopenings, which will, in time, result in a more efficient process. The first in a series of new forms is the Medicare Part B Reopenings Modifier Adjustment Request... more
Performant, Region 1 (which includes MI, IN, KY, OH, VT, NH, ME, MA, RI, CT and NY) has received approval from (CMS to begin recovery audit activity. Please visit the Performant website Provider Portal to view the CMS approved issues list or access additional information such as FAQs or Forms and Sample documents. Don’t forget to make sure your... more
When a Supplemental Medical Review Contractor (SMRC) or Recovery Audit (RA) contractor identifies improper payments, they notify the provider via a determination letter (also referred to as a review results letter). They also notify CGS to initiate the overpayment process. Once CGS is notified, the claim is adjusted and a remittance... more
CGS detected an issue in one of their claims processing translators impacting the number of units paid on Part B claims. This issue impacted claims submitted from January 2 – 5, 2017. To expedite proper payment, providers impacted should call the Part B Provider Contact Center (PCC) at 866.276.9558 (option 1). Please provide the date of the... more
CGS will be updating the current Reopening request forms for J15 Part B. Once the new forms are available, you will no longer be able to use the current forms you are using to request a reopening. Please remember to delete any saved forms you have in your files, and start using the new forms immediately from https://www.cgsmedicare.com/partb/... more