03/20/2019

How to contact Medicare and Medicare’s MAC's


Sections:


Medicare Phone Number


PECOS Contact Information


NPI Contact Information


MAC's Contact Information


We have all been the situation where we must contact Medicare, whether you are a Provider or even an individual trying to get answers to your Medicare questions like finding out whether or not your medicare eligibility.


The good news for providers you can Check Medicare eligibility fast and easily with our verification checker. It will provide you all the information you will need. Of course, that is only one of many reasons you may have to contact Medicare.


If you are a provider or an individual and need to contact Medicare directly you can do so through the following ways:


Contact Medicare by phone:

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


If you need to send paper forms to Medicare. You can send them to Medicare’s mailing address:


Medicare Contact Center Operations

PO Box 1270

Lawrence, KS 66044


State Health Insurance Assistance Program (SHIP)

which can answer questions about Personalized health insurance counseling

You will find your specfic states contact information here: SHIP



Provider Enrollment, Chain, and Ownership System (PECOS)

Finding the right contact information for your specific problem can a painstaking task itself. So below we give you the best way for each problem that you may have.


Let’s go over a few reasons why you may need to contact someone at CMS in regards to PECOS and give you the best way to get in contact with them:

  1. 1. You decide to use our real-time PECOS search to make sure you were in the system and noticed something wrong. Maybe your address or name was not correct.

  2. 2. You need to enroll in PECOS

In this case, you are right to assume you need to contact CMS, now if you are not currently enrolled in PECOS the first thing you will need to do is go here: PECOS Setup

This will allow you to set up an account and get yourself PECOS enrolled. The cost for your enrollment as of 2020 will be $595. You can now see your application status here: Application Status

You will also be setting up an MFA Code which is an added layer of protection for yourself, you will have the option of choosing to either receive this code through email or text.

Please be aware you will need to login and use your account within every 180 days or risk it being disabled and needing to reset your password.

If you need to contact someone for help filling out the PECOS enrollment you need to contact your MAC, we will go over who your MAC is and where to contact them below.

If you need help with one of the following:

  • 1. Forgotten password or Login ID

  • 2. Account registration questions

  • 3. System-error message while completing the application

  • 4. The system asks the user to contact System Administrator

  • 5. Questions about required/supporting document

  • 6. Revalidation questions


You will need to choose one of the following ways to contact the External User Services and here are the options to do so:


Phone number Toll-Free: (866) 484-8049

Try their live chat (available Monday - Friday: 06:00 AM CST - 06:00 PM CST)

(Saturday - Sunday: Closed)

Email them at : EUSSupport@cgi.com

Or mail them at : External User Services

PO Box 792750

San Antonio, Texas 78279

The above is the same if you have general questions about applying for PEOCS


National Provider Identifier (NPI)

How about if you find yourself searching for your NPI with our NPI Lookup and you notice an issue, Maye the wrong address is showing up, or wrong state, just to name a few or even if your in need of an NPI and do not know where you can acquire one.

What you’re going to want to do if your looking to get an NPI number will be to follow this link and set up an account: Here

Now if your one of the lucky people who have their Identity & Access Management System (I&A) User ID and Password you can go ahead and use that to access the site.


Change Information


You will have two choices to update or change information. The first is online, Please be aware that Changes to Date of Birth, Changes to Social Security Number, Reactivation of an NPI and Deactivation of an NPI cannot be completed online and we will go over what you need to do for them. But first, if you are looking to make other changes will need to follow the steps below once in the system:

  1. Select the “Magnifying Glass” ICON to View the desired NPI application.

  2. Select the “Pencil” ICON to Edit the desired NPI application

  3. Access the page that contains the information you want to be updated by selecting the ‘Next’ button located at the bottom of each page or by selecting the desired page from the left-hand navigation bar.

  4. Update the necessary information.

  5. Once all desired information is updated navigate to the Submission page. Check the Certification Statement box at the bottom of this page.

  6. Select Submit. This button will not be enabled until you check the Certification Statement box at the bottom of this page.


Changes to Date of Birth, Changes to Social Security Number, Reactivation of an NPI and Deactivation of an NPI will require a paper Application/Update Form

You can get this form two ways: The form is available for download by accessing it: Here or by requestion one by phone 1-800-465-3203


  1. In Section 1A Reason For Submittal of this Form, select the Change of Information box.

  2. Provide the correct NPI on the line below the Change of Information box.

  3. Complete the sections that need to be updated. If you are making an update to Section 3C Other Provider Identification Numbers or Section 3D Provider Taxonomy Code, be sure to indicate if the information is to be added to the NPI record or if it is to replace the information that is currently in the NPI record.

  4. In Section 4A or 4B Certification Statement, the Provider/Authorized Official will sign the application. Note: For Entity Type 1 applications, the Provider will sign in Section 4A.

For Entity Type 2 applications, the Authorized Official will sign in Section 4B.

  1. Once the paper NPI Application/Update form is completed, it must be returned to the NPI Enumerator via mail at the address provided on the third page of the application.


Can I change my taxonomy number?


Adding, Changing or Deleting a Taxonomy Code or Changing the Primary Taxonomy Online, can be done by a provider online by completing the steps below:

  1. On the Home Page of the NPPES website, enter your I&A User ID and password.

  2. Select the “Pencil” ICON in the Action column of the NPI you wish to modify.

  3. Navigate to the Taxonomy page by either:

  4. Selecting Taxonomy from the left navigation panel

  5. Selecting Taxonomy on the top progression bar.

  6. Selecting Next until you are navigated to the Taxonomy page.

  7. To change the Primary Taxonomy code, select the radio button next to the Taxonomy to designate which of the codes listed is the primary Taxonomy.

  8. To change or add a Taxonomy code:

  9. Select Add Taxonomy.

  10. Once you have selected the desired Taxonomy code, it will allow you to input an associated license and state of issue, if applicable.

  11. Select Save to store the new information and return to a list of all Taxonomy and licenses currently on the record.

  12. To delete a Taxonomy code:

  13. Select Delete associated with the Taxonomy code you wish to remove.

  14. Navigate to the Submission page

  15. Select Submit.


Medicare administrative contractors (MAC’s)


Sections:


CGS


Noridian


Palmetto GBA


First Coast Service Options


Novitas


NGS


WPS


As providers, we routinely need to contact our MAC’s whether it be a routine question about claims or in regards to another question about Medicare. The hard part is trying to figure out how to contact them.

There are three types of MAC’s, the first is the Medicare Part A and Part B MAC’s. The second handle Home Health and Hospice and the third handle all DME’s

These MAC’s process Medicare Part A and Medicare Part B claims, Home health and hospice claims and DME claims for certain areas in the United States, most providers call them MAC Jurisdictions. Each Jurisdiction is for a certain area servicing institutional providers, physicians, practitioners, and suppliers.


CGS Administrators


CGS covers the following Jurisdiction 15 Part A & B : Kentucky, Ohio

Home Health and Hospice: Delaware, District of Columbia, Colorado, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia, and Wyoming

DME Jurisdiction C: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, Puerto Rico, U.S. Virgin Islands

DME Jurisdiction B:Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, Wisconsin


Contact Information:

Website: CGS

Customer service phone number :

Part A Phone: 866.590.6703

Part B Phone: 866.276.9558

Part A :Telecommunications Devices for the Deaf (TTD/TTY)

Phone: 855.294.9889

Part B: Telecommunications Devices for the Deaf (TTD/TTY)

Phone: 888.270.9481


Part A:

  1. Option 1: Claims

  2. Option 2: Electronic Data Interchange (EDI)

  3. Option 3: Provider Enrollment (PE)

  4. Option 4: Overpayment Recovery (OPR)

  5. Option 9: General Inquiries

  6. (8:00 a.m. – 5:00 p.m. (EST))

Part B:

  1. Option 1: Claims

  2. Option 2: Electronic Data Interchange (EDI)

  3. Option 3: Provider Enrollment (PE)

  4. Option 4: Telephone Reopening (TRO)

  5. Option 5: Overpayment Recovery (OPR)

  6. Option 9: General Inquiries

  7. (8:00 a.m. – 5:00 p.m. (EST))

We advise you have the following information ready when you do call CGS:

  1. Your National Provider Identifier (NPI);

  2. Your Provider Transaction Access Number (PTAN);

  3. The last 5 digits of the provider Tax Identification Number (TIN); and

  4. Beneficiary's Medicare ID number, first name, last name and date of birth.

CGS Part A Mail:

CGS Administrators, LLC

J15 Part A PCC

PO Box 20200

Nashville, TN 37202

Appeals: CGS Administrators, LLC

J15 Part A PCC

PO Box 20200

Nashville, TN 37202

FedEx/UPS/Certified Mail:

CGS Administrators, LLC

J15 Part A Appeals

2 Vantage Way

Nashville, TN 37228

935 Appeals related to Overpayments:

CGS

J15 Part A Overpayments Appeals

PO BOX 20022

Nashville, TN 37202

Claims:

CGS Administrators, LLC

J15 Part A Claims

PO Box 20211

Nashville, TN 37202


Part B: J15 – Part A/B Correspondence

CGS Administrators, LLC

PO Box 20018

Nashville, TN 37202

Appeals:

J15 – Part A/B Correspondence

CGS Administrators, LLC

PO Box 20018

Nashville, TN 37202

FedEx/UPS/Certified Mail:

J15 – Part A/B Correspondence

CGS Administrators, LLC

2 Vantage Way

Nashville, TN 37228

Claims: J15 — Part B/HHH Claims

CGS Administrators, LLC

PO Box 20019

Nashville, TN 37202



CGS Home Health and Hospice

Contact Phone Number:

1.877.299.4500

Telecommunications Devices for the Deaf

Phone: 1.866.854.1876

  1. Option 1: Provider Contact Center (PCC) Questions (specific claim inquiries)

  2. Option 2: Electronic Data Interchange (EDI)

  3. Option 3: Provider Enrollment (PE)

  4. Option 4: Overpayment Recovery (OPR)

  5. Option 9: General Inquiries

  6. (8:00 a.m. – 4:30 p.m. (CT))

By Mail: J15 – HHH Correspondence

CGS Administrators, LLC

PO Box 20014

Nashville, TN 37202

Apeals: J15 – HHH Correspondence

CGS Administrators, LLC

PO Box 20014

Nashville, TN 37202


CGS DME Jurisdiction B and C Contact information

Jurisdiction B: Customer Service phone number:

866.590.6727

Hearing Impaired: 888.897.7534

Mail:

CGS

PO Box 20007

Nashville, TN 37202

Jurisdiction C:

Customer Service: 866.270.4909

Hearing Impaired: 888.204.3771

Mail:

CGS

PO Box 20010

Nashville, TN 37202

Noridian Healthcare Solutions

Noridian Covers the following areas:

Part A and Part B:

Jurisdiction E: California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands

Jurisdiction F: Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming

DME A:Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont

DME D:Alaska, Arizona, California, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands


Contact Information

Website:Noridian

Customer service phone number:

Jurisdiction E Part A and B:

855-609-9960

TTY: 855-549-9874

  1. Electronic Data Interchange Support Services (EDISS): (M-F 6 a.m. - 5 p.m. PT)

  2. Provider Contact Center (PCC): (M-F 6 a.m. - 5 p.m. PT)

  3. Provider Enrollment: (M-F 6 a.m. - 5 p.m. PT)

  4. Phone Reopenings: (M-F 6 a.m. - 5 p.m. PT)

  5. User Security: M-F (6 a.m. - 3 p.m. PT)

Email Contact form for both Jurisdictions:

Contact Noridian

Mail for Part A:

Mail Part A

Mail for Part B:

Mail Part B

DME Jurisdiction A :

866-419-9458 (M-F 8 a.m. - 5 p.m. ET)

TTY: 888-897-7539 (M-F 8 a.m. - 5 p.m. ET)

Email contact form DME Jurisdiction A:

Click Here

DME Jurisdiction A Mail:

Click Here

DME Jurisdiction D :

877-320-0390 (M-F 8 a.m. - 6 p.m. CT)

TTY: 866-879-2704 (M-F 8 a.m. - 6 p.m. CT)

Email contact form for DME Jurisdiction D:

Click Here

DME Jurisdiction D Mail:

Click Here


Palmetto GBA

Palmetto Covers the following areas:

Part A and Part B

Jurisdiction J: Alabama, Georgia, Tennessee

Jurisdiction M: North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia)

Home Health and Hospice:

Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas


Contact Information

Website: Palmetto

Customer service phone number:

Jurisdiction J Part A and B : 877-567-7271

Email contact form for Part A:

Email Here

Email contact form for part B:

Email Here

Mail for Part A:

Mailling Address

Mail for Part B:

Mailing Address


First Coast Service Options

First Coast Covers the following areas:

Part A and Part B

Jurisdiction N : Florida, Puerto Rico, U.S. Virgin Islands


Contact Information

Website: First Coast

Customer service phone number

Jurisdiction N Part A and B : 1 866-454-9007

Mail for Part A and B:

532 Riverside Avenue

Jacksonville, FL 32202


Novitas Solutions

Novitas Covers the following areas:

Part A and Part B

Jurisdiction H: Arkansas, Colorado, New Mexico, Oklahoma, Texas, Louisiana, Mississippi

Jurisdiction: L: Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania (includes Part B for counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia)

Contact Information

Website: Novitas

Customer service phone number

Jurisdiction H

1-855-252-8782

TTY 1- 855-498-2447

Jurisdiction L:

1-877-235-8073

TTY 1-877-235-8051

Email Jurisdiction H:

Email Here

Email Jurisdiction L:

Email Here

Mail for Jurisdiction H

Mailing Address

Mail for Jurisdiction L

Mailling Address


National Government Services (NGS)

NGS Covers the following areas:

Part A and Part B

Jurisdiction 6: Illinois, Minnesota, Wisconsin

Jurisdiction K: Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont

Contact Information

Home health and Hospice

Jurisdiction 6: Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, US Virgin Islands, Wisconsin and Washington

Jurisdiction K: : Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont

Website: NGS

Contact information for NGS can be found here: NGS Contact information


Wisconsin Physicians Service Government Health Administrators (WPS)

WPS Covers the following areas:

Part A and Part B

Jurisdiction 5: Iowa, Kansas, Missouri, Nebraska

Jurisdiction 8: Indiana, Michigan

Contact Information

Website: WPS

Customer service phone number:

Jurisdiction 5: 866-518-3285

Jurisdiction 8: 866-234-7331

Contact information can be found here:WPS Contact


We hope this information has proven valuable to you as it has for us here at Episode Alert. If you are ever in need of our services, please check us out at: Episode Alert



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