How to contact Medicare and Medicare’s MAC's
Sections:
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 sspecific 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. 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. 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:
Select the “Magnifying Glass” ICON to View the desired NPI application.
Select the “Pencil” ICON to Edit the desired NPI application
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.
Update the necessary information.
Once all desired information is updated navigate to the Submission page. Check the Certification Statement box at the bottom of this page.
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
In Section 1A Reason For Submittal of this Form, select the Change of Information box.
Provide the correct NPI on the line below the Change of Information box.
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.
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.
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:
On the Home Page of the NPPES website, enter your I&A User ID and password.
Select the “Pencil” ICON in the Action column of the NPI you wish to modify.
Navigate to the Taxonomy page by either:
Selecting Taxonomy from the left navigation panel
Selecting Taxonomy on the top progression bar.
Selecting Next until you are navigated to the Taxonomy page.
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.
To change or add a Taxonomy code:
Select Add Taxonomy.
Once you have selected the desired Taxonomy code, it will allow you to input an associated license and state of issue, if applicable.
Select Save to store the new information and return to a list of all Taxonomy and licenses currently on the record.
To delete a Taxonomy code:
Select Delete associated with the Taxonomy code you wish to remove.
Navigate to the Submission page
Select Submit.
Medicare administrative contractors (MAC’s)
Sections:
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:
Option 1: Claims
Option 2: Electronic Data Interchange (EDI)
Option 3: Provider Enrollment (PE)
Option 4: Overpayment Recovery (OPR)
Option 9: General Inquiries
(8:00 a.m. – 5:00 p.m. (EST))
Part B:
Option 1: Claims
Option 2: Electronic Data Interchange (EDI)
Option 3: Provider Enrollment (PE)
Option 4: Telephone Reopening (TRO)
Option 5: Overpayment Recovery (OPR)
Option 9: General Inquiries
(8:00 a.m. – 5:00 p.m. (EST))
We advise you have the following information ready when you do call CGS:
Your National Provider Identifier (NPI);
Your Provider Transaction Access Number (PTAN);
The last 5 digits of the provider Tax Identification Number (TIN); and
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
Option 1: Provider Contact Center (PCC) Questions (specific claim inquiries)
Option 2: Electronic Data Interchange (EDI)
Option 3: Provider Enrollment (PE)
Option 4: Overpayment Recovery (OPR)
Option 9: General Inquiries
(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
Electronic Data Interchange Support Services (EDISS): (M-F 6 a.m. - 5 p.m. PT)
Provider Contact Center (PCC): (M-F 6 a.m. - 5 p.m. PT)
Provider Enrollment: (M-F 6 a.m. - 5 p.m. PT)
Phone Reopenings: (M-F 6 a.m. - 5 p.m. PT)
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