CGS Administrators, LLC (CGS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdictions 15, which includes the state of Kentucky. If you are a provider located in the State of Kentucky and need to become an electronic submitter for your Medicare A/B Claims, please follow the enrollment instructions below. 

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed prior to initiation of electronic claims submission.

1. Online EDI Enrollment Application

2. EDI Enrollment Agreement
 

To obtain the forms above, please download them from:
https://www.cgsmedicare.com/partb/edi/enrollment.html

 

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

EDI Application

Section 1 - EDI Application

• Today's date should be prepopulated

• Please choose “Apply for New Submitter ID” from the dropdown

• Select your Line of Business from the dropdown

Section 2 - Submitter Information

• Please enter your Business or Provider Name as the Owner Name

• Leave the "Input Submitter ID" section blank

• Type of Submitter: Choose Provider or Billing Service (if YOU are a billing service)

• Please complete your demographic and contact information

Section 3 - Software Vendor & Network Service Vendor

• For name of Software Vendor, please enter the name of the vendor creating your ANSI 837 files that you will be uploading to CGS via our secure NSV connection

• Please enter "Axiom sys" in the Network Service Vendor field (their online form will not let you enter the entire name)

Section 4 -Provider Information

• Please enter your Organization/Group Practice information

• If you have more than one Billing Provider, check the box at the bottom "Add another Provider" then enter that providers information

• Please select "No" in response to the question "Would you like to order software?"

• Press "Submit"

EDI Enrollment Agreement

• Please enter your Group Practice/Provider Name, Address, and NPI

• Once your information is entered please print your name, title, date, and sign the application

Submitting your Forms

It is recommended that you keep a copy of these forms for your records and if sending by mail, be sure to send documents with original signatures to:

J15 Correspondence

CGS

PO Box 20018

Nashville, TN 37202

Faxing is recommended for faster service

J15 Fax: 615-782-4459

Waiting for a Response

After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Technology Support Center toll-free at the number for your line of business: Part A 1-866-590-6703 or Part B 1-866-276-9558.

Testing

Once you have received your Submitter ID and Password from CGS, please call the SolAce Support Team and set an appointment for a Mailbox setup and Test Transmission to NGS.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.