Recent updates to the myCGS portal now permit users to access TPE audit correspondence and introduces secure messaging features. That's useful, but we think it could be a sign of bigger things to come.
TPE Audit Correspondence
Version 5.3 added features that provide users access to Additional Documentation Request (ADR) communications. The MACs generate ADRs, or development letters, to request information from suppliers on Targeted Probe and Educate (TPE) audited claims. From myCGS, suppliers can:
myCGS Accepts Five File Types for Upload
When suppliers submit responses to ADRs through the portal, myCGS allows them to upload five different file types: DOC, DOCX, PDF, RTF, and TIFF. As of June 15, 2019, CGS has an active alert regarding portal messaging on file types. Contrary to portal instructions, CGS does not accept ZIP or TXT files. The alerts page instructs users to ignore the portal instructions and only upload documents in one of the five supported file types.
Secure Messaging
Version 5.4 added a secure messaging feature to the portal allowing suppliers to receive notifications from, and respond to, CGS regarding curable errors.
Suppliers can only respond to messages from CGS, they cannot initiate independent inquiries. Approved users will receive an email notification when a new message is pending in the portal. Upon login, approved users will also see an inbox alert with the number of unread messages.
TPE Audit Correspondence
Version 5.3 added features that provide users access to Additional Documentation Request (ADR) communications. The MACs generate ADRs, or development letters, to request information from suppliers on Targeted Probe and Educate (TPE) audited claims. From myCGS, suppliers can:
- Find all open and closed ADR cases.
- Check the status of ADR cases.
- View the details of ADR claims.
- View a copy of the most current ADR letter.
- Submit responses to the ADR.
- View a summary of any education.
myCGS Accepts Five File Types for Upload
When suppliers submit responses to ADRs through the portal, myCGS allows them to upload five different file types: DOC, DOCX, PDF, RTF, and TIFF. As of June 15, 2019, CGS has an active alert regarding portal messaging on file types. Contrary to portal instructions, CGS does not accept ZIP or TXT files. The alerts page instructs users to ignore the portal instructions and only upload documents in one of the five supported file types.
Secure Messaging
Version 5.4 added a secure messaging feature to the portal allowing suppliers to receive notifications from, and respond to, CGS regarding curable errors.
Suppliers can only respond to messages from CGS, they cannot initiate independent inquiries. Approved users will receive an email notification when a new message is pending in the portal. Upon login, approved users will also see an inbox alert with the number of unread messages.
When CGS receives documentation from suppliers for TPE audits, the nurse reviewers may identify missing elements or documents. Suppliers are afforded an opportunity to fix these “curable errors.” CGS will message suppliers in the portal and allow five days for a response. If the supplier does not respond, the claim will automatically deny after 10 days.
CGS automatically grants access to the secure messaging feature to designated approvers. Designated approvers can grant access to additional end users as needed.
At MiraVista, we believe these recent feature additions provide a foundation to eventually support prior authorization requests and appeal submissions in future updates.
SOURCE LINKS
https://cgsmedicare.com/jb/pubs/news/2019/02/cope11380.html
https://cgsmedicare.com/jb/pubs/news/2019/06/cope12792.html
https://cgsmedicare.com/jb/mycgs/alerts.html
CGS automatically grants access to the secure messaging feature to designated approvers. Designated approvers can grant access to additional end users as needed.
At MiraVista, we believe these recent feature additions provide a foundation to eventually support prior authorization requests and appeal submissions in future updates.
SOURCE LINKS
https://cgsmedicare.com/jb/pubs/news/2019/02/cope11380.html
https://cgsmedicare.com/jb/pubs/news/2019/06/cope12792.html
https://cgsmedicare.com/jb/mycgs/alerts.html
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