After receiving the contract from CMS in September, 2015, CGS Administrators LLC will begin processing Medicare claims for Jurisdiction B on Mon., June 27.
As Jurisdiction B DME MAC, CGS will serve Medicare beneficiaries in Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. Jurisdiction B includes more than 6.8 million Medicare fee-for-service beneficiaries, and will serve approximately 18,000 Medicare HME providers. This jurisdiction comprises nearly 21 percent of Medicare’s to fee-for-service DMEPOS claims volume.
CMS will oversee the transfer of DME MAC work from the current contractor, National Government Services, to CGS over the next several months. NGS will process all claims submitted thru Fri., June 24, and then CGS will take over processing as of Mon., June 27.
Some details about the transition:
- All electronic claims go thru the CEDI gateway, and providers will use the same submitter/transmitter numbers. CEDI will (electronically) examine the claim file, and stream it to CGS rather than NGS.
- Providers should not have to do any updates to EFTs and ERNs.
- There will be a transition time frame during which NGS will continue to work the claims that it received prior to the cut-off date. After a period of time to be determined by CMS. NGS will stop work and pass all open claims over to CGS.
- Any claims denied June 27 or after will go to CGS for appeal.
Already the contractor for Jurisdiction C, once CGS becomes the contractor for Jurisdiction B, it will separately administer the two Jurisdictions.
Providers can get more information via summary document from the Jurisdiction B Council at bit.ly/1PWG6fM, or via the implementation help line, which is available Monday through Friday, from 1 to 5 p.m. Central Time at (877) 363-8895.