CGS announced on February 17th, via published FAQs that they will officially take over the Jurisdiction B DME MAC contract as of July 5th. This provides a definitive timeline for the contractor to complete the behind the scenes transition before assuming the 20% claims volume influx.
Another hot topic addressed in the FAQ is the status of the myCGS provider portal registration window for Jurisdiction B suppliers. The agency has stated that myCGS registration will open for Jurisdiction B suppliers three weeks prior to the implementation of the contract. In a CGS Implementation ACT Call conducted on March 24th, the contractor indicated that this will be a simplified, express-type registration to facilitate the transition. Jurisdiction B suppliers will receive a written invitation to pre-register for the portal prior to implementation and should be looking out for correspondence regarding myCGS registration.
Another hot topic addressed in the FAQ is the status of the myCGS provider portal registration window for Jurisdiction B suppliers. The agency has stated that myCGS registration will open for Jurisdiction B suppliers three weeks prior to the implementation of the contract. In a CGS Implementation ACT Call conducted on March 24th, the contractor indicated that this will be a simplified, express-type registration to facilitate the transition. Jurisdiction B suppliers will receive a written invitation to pre-register for the portal prior to implementation and should be looking out for correspondence regarding myCGS registration.
In the FAQ, CGS stated that any work (claims processing, appeals processing, etc.) left unfinished by the prior Jurisdiction B DME MAC contract holder (National Government Services) will be officially transitioned to CGS for completion. Paper claims submitted for beneficiaries in Jurisdiction B should continue to be routed through the incumbent contractor until further instructions are provided with a new mailing address.
Per a CMS Change Request 9526, electronic claims will continue to be transmitted via the CEDI gateway with the current carrier ID for Jurisdiction B (17003); however, after the cutover, transactions will need to be sent with a new carrier ID (17013). The carrier ID is the payer identification number used by CEDI to identify the appropriate DME MAC, however the beneficiary address in the claim transaction is ultimately utilized to route claims appropriately between the four DME MACs. We expect CEDI to eventually reject batches of claims with outdated carrier IDs. Carrier IDs are established and linked to your insurance payers directly within your billing system. If you are unsure of how to modify the carrier IDs/payer IDs linked to your Jurisdiction B Medicare insurance record, contact your billing software vendor. The ProACE Pro32 free billing software will be updated to reflect these changes and made available to suppliers.
Per a CMS Change Request 9526, electronic claims will continue to be transmitted via the CEDI gateway with the current carrier ID for Jurisdiction B (17003); however, after the cutover, transactions will need to be sent with a new carrier ID (17013). The carrier ID is the payer identification number used by CEDI to identify the appropriate DME MAC, however the beneficiary address in the claim transaction is ultimately utilized to route claims appropriately between the four DME MACs. We expect CEDI to eventually reject batches of claims with outdated carrier IDs. Carrier IDs are established and linked to your insurance payers directly within your billing system. If you are unsure of how to modify the carrier IDs/payer IDs linked to your Jurisdiction B Medicare insurance record, contact your billing software vendor. The ProACE Pro32 free billing software will be updated to reflect these changes and made available to suppliers.
Join MiraVista and HME News on May 4th as we breakdown what this transition will look like for all suppliers impacted by the two major transitions of the Jurisdiction A and B contracts. We will succinctly address topics related to claim submission protocols, audit activity, payment considerations, accessibility, and more. We want to address your concerns and ensure you are prepared to minimize potential disruptions. Reserve your seat here.
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