Provider Contact Center

Want to talk to us?

Note: The PCC will close twice a month for training and staff development. The PCC closures for training will be 12:00 p.m.–4:00 p.m. ET on the 2^nd and 4^th Friday of each month for all locations. This schedule was determined based on our lowest call volume times to reduce impact to our providers.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. To fully comply with this requirement effective 5/14/2018, if you contact the PCC, and the information you are requesting is available via the IVR or NGSConnex, the PCC will be required to direct you to the IVR or NGSConnex to obtain the information.

Make the Most of Your Call

Be prepared to have the following information available:

• NPI
• PTAN
• The last five digits of your TIN

Note: You are allowed three attempts to correctly provide your NPI, PTAN and last five digits of your TIN.

The following is required for claim-specific inquiries:

• Patients Medicare Identification Number
• Patient’s last name and first name or initial (date of birth may be needed)
• The date(s) of service in question
• Denial reason (if unknown please call IVR)

Please view our corporate holiday schedule to learn when the National Government Services PCC will be closed.

Customer Care Representative Assistance

The National Government Services PCC CCRs are available to assist you with a wide-range of Medicare coverage and billing-related inquiries. Please review the following information for a better understanding of the types of inquiries the CCRs are available to assist you with.

CCRs are available to:

• clarify why a claim processed the way it did;
• assist with general Medicare information/billing questions;
• provide guidance on how to use the IVR system and the NGSMedicare.com website; and
• assist with other complex issues that cannot be addressed through the IVR system.

CCRs are not able to:

• provide claim status, beneficiary eligibility, or any other information that is available through NGSConnex or the IVR system;
• provide information on what modifiers, diagnosis codes, CPT codes or HCPCS to use for specific claims or beneficiaries;
• preauthorize any type of service or supply; and
• answer inquiries from beneficiaries or their representatives.

Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR or in NGSConnex, you will be referred back to those self-help tools.

Interactive Voice Response System

Hours Available*

Monday–Friday: 6:00 a.m.–7:00 p.m. ET
Saturday: 7:00 a.m.–3:00 p.m. ET

*IVR hours represent general availability for access to all menu options. The IVR is available 24-hours a day, seven days a week. Menu options that require system access (e.g., CWF) are limited to that systems availability.

NGSConnex Online Inquiry System

NGSConnex is the National Government Service web application developed just for you! NGSConnex allows you to access a wide array of Medicare tools and information, such as:

• Beneficiary eligibility and entitlement information
• Query for your claims status
• View your provider/supplier demographic information
• Query for your financial data
• View and print your remittance advice
• Submit an online inquiry
  

NGSConnex offers you superior search capabilities that will help make it fast and easy for you to find the information without having to call the National Government Services PCC.

Written Correspondence and Inquiries

If you are unable to use NGSConnex, then you may download and input your inquiry directly onto the Medicare Correspondence Request Form. Once completed, print and either fax to 317-841-4584 or mail to the appropriate address as indicated on the form.

Otherwise, submit inquiry on official letterhead with provider’s name and address(s). View the P.O. Box Mailing Addresses to find the correct address to send your written inquiry to for your state.

The following provider information is required on ALL written correspondence and inquiries:

• NPI
• PTAN
• Last 5 digits of TIN
• Provider’s name and address (must match enrollment information with MAC)

In most cases, NGS will respond via letter to the provider address on file within 45 business days.

Freedom of Information Act (FOIA) Inquiries

Requests for documents covered by the FOIA must be submitted to the following address in writing.

National Government Services, Inc.
P.O. Box 6131
Indianapolis, IN 46206-6131

Fax: 317-913-6590

Centers for Medicare & Medicaid Services Offices

CMS has central offices located in Baltimore, MD and Washington, D.C., and ten regional offices located throughout the country.

Provider Contact Center

Want to talk to us?

Note: The PCC will close twice a month for training and staff development. The PCC closures for training will be 12:00 p.m.–4:00 p.m. ET on the 2^nd and 4^th Friday of each month for all locations. This schedule was determined based on our lowest call volume times to reduce impact to our providers.

Please view our holiday schedule to learn when the National Government Services PCC is closed.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. To fully comply with this requirement effective 5/14/2018, if you contact the PCC, and the information you are requesting is available via the IVR or NGSConnex, the PCC will be required to direct you to the IVR or NGSConnex to obtain the information.

Make the Most of Your Call

Be prepared to have the following information available:

• NPI
• PTAN
• The last five digits of your TIN

Note: You are allowed three attempts to correctly provide your NPI, PTAN and last five digits of your TIN.

The following is required for claim-specific inquiries:

• Patients Medicare Identification Number
• Patient's last name and first name or initial (date of birth may be needed)
• The date(s) of service in question
• Denial reason (if unknown please call IVR)

Customer Care Representative Assistance

The National Government Services PCC CCRs are available to assist you with a wide-range of Medicare coverage and billing-related inquiries. Please review the following information for a better understanding of the types of inquiries the CCRs are available to assist you with. 

Note: To effectively service all callers, each call is limited to three inquiries.

CCRs are available to:

• clarify why a claim processed the way it did;
• assist with general Medicare information/billing questions;
• provide guidance on how to use the IVR system and the website; and
• assist with other complex issues that cannot be addressed through the IVR system.

CCRs are not able to:

• provide claim status, beneficiary eligibility, or any other information that is available through NGSConnex or the IVR system;
• provide information on what modifiers, diagnosis codes, CPT codes or HCPCS to use for specific claims or beneficiaries;
• preauthorize any type of service or supply; and
• answer inquiries from beneficiaries or their representatives.

Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR or in NGSConnex, you will be referred back to those self-help tools.

Interactive Voice Response

Hours Available*

Monday–Friday: 6:00 a.m.–7:00 p.m. ET
Saturday: 7:00 a.m.–3:00 p.m. ET

*Interactive voice response (IVR) system hours represent general availability for access to all menu options. The IVR system is available 24-hours a day, seven days a week. Menu options that require system access (e.g., CWF) are limited to that systems availability.

NGSConnex Online Inquiry System

NGSConnex is the National Government Services online portal Web application developed by National Government Service just for you! NGSConnex allows you to access a wide array of Medicare tools and information, such as:

• Beneficiary eligibility and entitlement information
• Query for your claims status
• View your provider/supplier demographic information
• Query for your financial data
• View and print your remittance advice
• Submit an online inquiry
  

NGSConnex is available at https://www.ngsconnex.com and offers you superior search capabilities that will help make it fast and easy for you to find the information without having to call the National Government Services PCC.

Written Correspondence and Inquiries

If you are unable to use NGSConnex, then you may download and input your inquiry directly onto the Medicare Correspondence Request Form. Once completed, print and either fax to 317-841-4584 or mail to the appropriate address as indicated on the form.

Otherwise, submit inquiry on official letterhead with provider’s name and address(s). View the P.O. Box Mailing Addresses to find the correct address to send your written inquiry to for your state.

The following provider information is required on ALL written correspondence and inquiries:

• NPI
• PTAN
• Last 5 digits of TIN
• Provider’s name and address (must match enrollment information with MAC)

In most cases, NGS will respond via letter to the provider address on file within 45 business days.

Freedom of Information Act (FOIA) Inquiries

National Government Services, Inc.
P.O. Box 6131
Indianapolis, IN 46206-6131

Fax: 317-913-6590

Centers for Medicare & Medicaid Services Offices

CMS has central offices located in Baltimore, MD and Washington, D.C., and has ten regional offices located throughout the country.

Provider Contact Center

Want to talk to us?

Note: The PCC will close twice a month for training and staff development. The PCC closures for training will be 12:00 p.m.–4:00 p.m. ET on the 2^nd and 4^th Friday of each month for all locations. This schedule was determined based on our lowest call volume times to reduce impact to our providers.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. To fully comply with this requirement effective 5/14/2018, if you contact the PCC, and the information you are requesting is available via the IVR or NGSConnex, the PCC will be required to direct you to the IVR or NGSConnex to obtain the information.

Make the Most of Your Call

Be prepared to have the following information available:

• NPI
• PTAN
• The last five digits of your TIN

Note: You are allowed three attempts to correctly provide your NPI, PTAN and last five digits of your TIN.

The following is required for claim-specific inquiries:

• Patients Medicare Identification Number
• Patient's last name and first name or initial (date of birth may be needed)
• The date(s) of service in question
• Denial reason (if unknown please call IVR)|

Please view our holiday schedule to learn when the National Government Services PCC will be closed.

Customer Care Representative Assistance

The National Government Services PCC CCRs are available to assist you with a wide-range of Medicare coverage and billing-related inquiries. Please review the following information for a better understanding of the types of inquiries the CCRs are available to assist you with.

CCRs are available to:

• clarify why a claim processed the way it did;
• assist with general Medicare information/billing questions;
• provide guidance on how to use the IVR system and the NGSMedicare.com website; and
• assist with other complex issues that cannot be addressed through the IVR system.

CCRs are not able to:

• provide claim status, beneficiary eligibility, or any other information that is available through NGSConnex or the IVR system;
• provide information on what modifiers, diagnosis codes, CPT codes or HCPCS to use for specific claims or beneficiaries;
• preauthorize any type of service or supply; and
• answer inquiries from beneficiaries or their representatives.

Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR or in NGSConnex, you will be referred back to those self-help tools.

Interactive Voice Response System

Hours Available*

Monday–Friday: 6:00 a.m.–7:00 p.m. ET
Saturday: 7:00 a.m.–3:00 p.m. ET

*IVR hours represent general availability for access to all menu options. The IVR is available 24-hours a day, seven days a week. Menu options that require system access (e.g., CWF) are limited to that systems availability.

NGSConnex Online Inquiry System

NGSConnex is the National Government Services web application developed just for you! NGSConnex allows you to access a wide array of Medicare tools and information, such as:

• Beneficiary eligibility and entitlement information
• Query for your claims status
• View your provider/supplier demographic information
• Query for your financial data
• View and print your remittance advice
• Submit an online inquiry
  

NGSConnex is available at https://www.ngsconnex.com and offers you superior search capabilities that will help make it fast and easy for you to find the information without having to call the National Government Services PCC.

Written Correspondence and Inquiries

If you are unable to use NGSConnex, then you may download and input your inquiry directly onto the Medicare Correspondence Request Form. Once completed, print and either fax to 317-841-4584 or mail to the appropriate address as indicated on the form.

Otherwise, submit inquiry on official letterhead with provider’s name and address(s). View the P.O. Box Mailing Addresses to find the correct address to send your written inquiry to for your state.

The following provider information is required on ALL written correspondence and inquiries:

• NPI
• PTAN
• Last 5 digits of TIN
• Provider’s name and address (must match enrollment information with MAC)

In most cases, NGS will respond via letter to the provider address on file within 45 business days.

Freedom of Information Act (FOIA) Inquiries

Requests for documents covered by the FOIA must be submitted to the following address in writing.

National Government Services, Inc.
P.O. Box 6131
Indianapolis, IN 46206-6131

Fax: 317-913-6590

Centers for Medicare & Medicaid Services Offices

CMS has central offices located in Baltimore, MD and Washington, D.C., and ten regional offices located throughout the country.

Provider Contact Center

Want to talk to us?

Note: The PCC will close twice a month for training and staff development. The PCC closures for training will be 12:00 p.m.–4:00 p.m. ET on the 2^nd and 4^th Friday of each month for all locations. This schedule was determined based on our lowest call volume times to reduce impact to our providers.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. To fully comply with this requirement effective 5/14/2018, if you contact the PCC, and the information you are requesting is available via the IVR or NGSConnex, the PCC will be required to direct you to the IVR or NGSConnex to obtain the information.

Make the Most of Your Call

Be prepared to have the following information available:

• NPI
• PTAN
• The last five digits of your TIN

Note: You are allowed three attempts to correctly provide your NPI, PTAN and last five digits of your TIN.

The following is required for claim-specific inquiries:

• Patients Medicare Identification Number
• Patient's last name and first name or initial (date of birth may be needed)
• The date(s) of service in question
• Denial reason (if unknown please call IVR)   

Please view our holiday hours schedule to learn when the National Government Services PCC will be closed.

Customer Care Representative Assistance

The National Government Services PCC CCRs are available to assist you with a wide-range of Medicare coverage and billing-related inquiries. Please review the following information for a better understanding of the types of inquiries the CCRs are available to assist you with.

CCRs are available to:

• clarify why a claim processed the way it did;
• assist with general Medicare information/billing questions;
• provide guidance on how to use the IVR system and the NGSMedicare.com website; and
• assist with other complex issues that cannot be addressed through the IVR system.

CCRs are not able to:

• provide claim status, beneficiary eligibility, or any other information that is available through NGSConnex or the IVR system;
• provide information on what modifiers, diagnosis codes, CPT codes, or HCPCS to use for specific claims or beneficiaries;
• preauthorize any type of service or supply; and
• answer inquiries from beneficiaries or their representatives.

Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR or in NGSConnex, you will be referred back to those self-help tools.

Interactive Voice Response

Hours Available*

Monday–Friday: 6:00 a.m.–7:00 p.m. ET
Saturday: 7:00 a.m.–3:00 p.m. ET

*IVR system hours represent general availability for access to all menu options. The IVR system is available 24-hours a day, seven days a week. Menu options that require system access (e.g., the CWF) are limited to that systems availability.

NGSConnex Online Inquiry System

NGSConnex is the National Government Service web application developed just for you! NGSConnex allows you to access a wide array of Medicare tools and information, such as:

• Beneficiary eligibility and entitlement information
• Query for your claims status
• View your provider/supplier demographic information
• Query for your financial data
• View and print your remittance advice
• Submitt an online inquiry
  

NGSConnex is available at https://www.NGSConnex.com and offers you superior search capabilities that will help make it fast and easy for you to find the information without having to call the National Government Services PCC.

Written Correspondence and Inquiries

If you are unable to use NGSConnex, then you may download and input your inquiry directly onto the Medicare Correspondence Request Form. Once completed, print and either fax to 317-841-4584 or mail to the appropriate address as indicated on the form.

Otherwise, submit inquiry on official letterhead with provider’s name and address(s). View the P.O. Box Mailing Addresses to find the correct address to send your written inquiry to for your state.

The following provider information is required on ALL written correspondence and inquiries:

• NPI
• PTAN
• Last 5 digits of TIN
• Provider’s name and address (must match enrollment information with MAC)

In most cases, NGS will respond via letter to the provider address on file within 45 business days.

Freedom of Information Act (FOIA) Inquiries

Requests for documents covered by the FOIA must be submitted to the following address in writing.

National Government Services, Inc.
P.O. Box 6131
Indianapolis, IN 46206-6131

Fax: 317-913-6590

Centers for Medicare & Medicaid Services Offices

CMS has central offices located in Baltimore, MD and Washington, D.C., and ten regional offices located throughout the country.

Interactive Voice Response System

*IVR hours represent general availability for access to all menu options. The IVR is available 24-hours a day, seven days a week. Menu options that require system access (e.g., the Common Working File) are limited to that systems availability.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. As a result, NGS has developed an IVR system to assist you in answering many general questions with additional assistance. The IVR uses natural language and text-to-speech technology that responds to your voice. Touch tone is also available throughout the application, as needed.

Information you can obtain includes: patient eligibility, claim status, deductibles, check information and some general information. Our Provider Contact Center Representatives are available to assist you with more complex inquiries that require extra time and attention.

The IVR is maintained on a separate line from our Customer Care Representatives and is available beyond the normal contact center hours. As a result, you have greater access to the information you need when you need it.

Please Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR, or in NGSConnex, you will be referred back to those self-help tools.

• Part A Provider IVR User Guide
• Part A IVR Flow Chart
• Part A Touch-Tone Card/Eligibility Checklist
• Using the IVR to Avoid Top Claim Rejections and Return to Provider Errors (210 KB)

Interactive Voice Response System

*IVR hours represent general availability for access to all menu options. The IVR is available 24-hours a day, seven days a week. Menu options that require system access (e.g., the Common Working File) are limited to that systems availability.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. As a result, NGS has developed an IVR system to assist you in answering many general questions with additional assistance. The IVR uses natural language and text-to-speech technology that responds to your voice. Touch tone is also available throughout the application, as needed.

Information you can obtain includes: patient eligibility, claim status, deductibles, check information and some general information. Our Provider Contact Center Representatives are available to assist you with more complex inquiries that require extra time and attention.

The IVR is maintained on a separate line from our Customer Care Representatives and is available beyond the normal contact center hours. As a result, you have greater access to the information you need when you need it.

Please Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR, or in NGSConnex, you will be referred back to those self-help tools.

• Part B Provider IVR User Guide (397 KB)
• Part B Touch-Tone Card/Eligibility Checklist (250 KB)

Interactive Voice Response System

Toll-Free Number

877-309-4290

Hours Available*

Monday–Friday: 6:00 a.m.–7:00 p.m. ET
Saturday: 7:00 a.m.–3:00 p.m. ET

*IVR hours represent general availability for access to all menu options. The IVR is available 24-hours a day, seven days a week. Menu options that require system access (e.g., the Common Working File) are limited to that systems availability.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. As a result, NGS has developed an IVR system to assist you in answering many general questions with additional assistance. The IVR uses natural language and text-to-speech technology that responds to your voice. Touch tone is also available throughout the application, as needed.

Information you can obtain includes: patient eligibility, claim status, deductibles, check information and some general information. Our Provider Contact Center Representatives are available to assist you with more complex inquiries that require extra time and attention.

The IVR is maintained on a separate line from our Customer Care Representatives and is available beyond the normal contact center hours. As a result, you have greater access to the information you need when you need it.

Please Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR, or in NGSConnex, you will be referred back to those self-help tools.

• Part A Provider IVR User Guide
• Part A IVR Flow Chart
• Part A IVR Navigation Guide
• Part A Touch-Tone Card/Eligibility Checklist
• Using the IVR to Avoid Top Claim Rejections and Return to Provider Errors (210 KB)

Interactive Voice Response System

*IVR hours represent general availability for access to all menu options. The IVR is available 24-hours a day, seven days a week. Menu options that require system access (e.g., the Common Working File) are limited to that systems availability.

The CMS requires that Medicare contractors offer self-service options to their providers for general inquiries. CMS also requires providers to use these self-service options. As a result, NGS has developed an IVR system to assist you in answering many general questions with additional assistance. The IVR uses natural language and text-to-speech technology that responds to your voice. Touch tone is also available throughout the application, as needed.

Information you can obtain includes: patient eligibility, claim status, deductibles, check information and some general information. Our Provider Contact Center Representatives are available to assist you with more complex inquiries that require extra time and attention.

The IVR is maintained on a separate line from our Customer Care Representatives and is available beyond the normal contact center hours. As a result, you have greater access to the information you need when you need it.

Please Note: Based on CMS requirements, if you call a Customer Care Representative with a question that can be answered by the IVR, or in NGSConnex, you will be referred back to those self-help tools.

• Part A Provider IVR User Guide
• Part A IVR Flow Chart
• Part A IVR Navigation Guide
• Part A Touch-Tone Card/Eligibility Checklist

EDI Help Desk Information

Toll-Free Number

• Jurisdiction 6: 877-273-4334
• Jurisdiction K: 888-379-9132

Hours of Operation

Monday–Friday: 8:00 a.m.–5:00 p.m. ET

* Closed for training on the 2^nd and 4^th Friday of the month from 12:00–4:00 p.m. ET

EDI Email Inquiry Form Information

• EDI Email Inquiry Form
• EDI Email Inquiry Form Assistance
• EDI Help Desk Email Terms of Service
• Protected Health Information and Personally Identifiable Information Email Guidelines

P.O. Box Mailing Addresses

There has been no change to the P.O. Boxes used for remitting payment for Medicare Trust Fund debts. Please refer to addresses found on demand letters and overpayment recovery forms to make payments on debts to the Medicare Trust Fund.

We encourage you to send business mail via the United States Postal Service Office (USPS). The USPS delivers to specific Post Office Boxes allowing for faster receipt, timely processing, and enhanced service to you.

P.O. Box Mailing Addresses

Please note the following county assignments for downstate and upstate New York.

Downstate: Bronx, Columbia, Delaware, Dutchess, Greene, Kings, Nassau, New York, Orange, Putnam, Queens County, Richmond, Rockland, Suffolk, Sullivan, Ulster, West Chester

Upstate: Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Cortland, Erie, Essex, Franklin, Fulton, Genesee, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Montgomery, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Schuyler, Seneca, Steuben, St. Lawrence, Tioga, Tompkins, Warren, Washington, Wayne, Wyoming, Yates

* There has been no change to the P.O. boxes used for remitting payment for Medicare Trust Fund debts. Please refer to addresses found on demand letters and overpayment recovery forms to make payments on debts to the Medicare Trust Fund.

We encourage you to send business mail via the USPS. The USPS delivers to specific post office boxes allowing for faster receipt, timely processing and enhanced service to you.

P.O. Box Mailing Addresses

There has been no change to the P.O. Boxes used for remitting payment for Medicare Trust Fund debts. Please refer to addresses found on demand letters and overpayment recovery forms to make payments on debts to the Medicare Trust Fund.

We encourage you to send business mail via the USPS. The USPS delivers to specific Post Office Boxes allowing for faster receipt, timely processing, and enhanced service to you.

P.O. Box Mailing Addresses

There has been no change to the P.O. Boxes used for remitting payment for Medicare Trust Fund debts. Please refer to addresses found on demand letters and overpayment recovery forms to make payments on debts to the Medicare Trust Fund.

P.O. Box Mailing Addresses

There has been no change to the P.O. Boxes used for remitting payment for Medicare Trust Fund debts. Please refer to addresses found on demand letters and overpayment recovery forms to make payments on debts to the Medicare Trust Fund.

Toll-Free Provider Enrollment Numbers

National Government Services offers dedicated telephone lines for provider enrollment inquiries. Please use the toll-free provider enrollment number designated for your region:

Jurisdiction 6

Jurisdiction K

Provider Enrollment

The National Government Services Provider Customer Care Department has direct telephone lines available for provider enrollment inquiries.

Toll-Free Provider Enrollment Numbers

Please use the following toll-free provider enrollment number for your region:

Please Note: Provider enrollment representatives will only be able to assist those listed as the contact person on the application, the provider themselves, and/or the authorized/delegated official for the practice.

When to Contact the Provider Enrollment Lines

Contact the Provider Enrollment line regarding the following:

• Enrollment status
• Assistance with the CMS-855 form completion, and
• Other enrollment-related questions

Questions pertaining to issues other than the above should be directed to the Provider Contact Center.

Please have the following information ready when you call so we can help answer your questions as quickly as possible:

• Case number (if assigned)
• PTAN
• NPI
• Section of the application you are questioning (if applicable)

Appeals

Administrative Law Judge Reviews

Send written requests for an ALJ hearing to the entity specified in the QIC’s reconsideration notice. The notice will include the address for filing a request for ALJ hearing.

Medicare Appeals Council Reviews

Send requests for a MAC review to:

Department of Health and Human Services
Departmental Appeals Board, MS 6127
Medicare Appeals Council
330 Independence Avenue, SW
Cohen Building, Room G-644
Washington, DC 20201

Federal Court/Judicial Reviews

Send requests for a judicial review to:

Department of Health and Human Services
General Counsel
200 Independence Avenue, SW
Washington, DC 20201

Related Content

• • Appeals site area
  • Office of Medicare Hearings and Appeals

Appeals

Reopenings

Telephone Reopening Unit

Redeterminations

Appeals

Administrative Law Judge Reviews

Send written requests for an ALJ hearing to the entity specified in the QIC’s reconsideration notice. The notice will include the address for filing a request for ALJ hearing.

Medicare Appeals Council Reviews

Send requests for a MAC review to:

Department of Health and Human Services
Departmental Appeals Board, MS 6127
Medicare Appeals Council
330 Independence Avenue, SW
Cohen Building, Room G-644
Washington, DC 20201

Federal Court/Judicial Reviews

Send requests for a judicial review to:

Department of Health and Human Services
General Counsel
200 Independence Avenue, SW
Washington, DC 20201

Related Content

• • Appeals site area
  • Office of Medicare Hearings and Appeals

Please Note: General inquiries related to Medicare coverage policies, local and national coverage determinations, billing and reimbursement must be directed to the Provider Contact Center. Additional Medical Policy contact information is listed below.

Investigational Device Exemption Requests

Contact the Medical Policy Unit at NGSIDEREQUESTS@anthem.com for questions about:

• Investigational Device Exemptions (or to make IDE requests)
• Coverage for new technology

LCD Reconsiderations

Contact the Medical Policy Unit at NGS.LCD.reconsideration@anthem.com for questions concerning reconsideration of an active LCD.

Commenting on Draft LCDs

When draft LCDs are available, comments can be made by viewing drafts on the Medicare Coverage Database and selecting the 'Draft Contact' email link at the end of the LCD. Comments will only be considered if submitted during the formal comment period. Please send all draft comments to PartBLCDComments@anthem.com.

-Or-

National Government Services, Inc.
LCD Comments
P.O. Box 7108
Indianapolis, IN 46207-7108

Contractor Medical Director

Submit inquiries to the NGS CMDs at NGSCMD@anthem.com, only on clinical issues related to Medicare coverage.

Please Note: General inquiries related to Medicare coverage policies, local and national coverage determinations, billing and reimbursement must be directed to the Provider Contact Center. Additional Medical Policy contact information is listed below.

Investigational Device Exemption Requests

Contact the Medical Policy Unit at NGSIDERequests@anthem.com for questions about:

• Investigational device exemptions (or to make IDE requests)
• Coverage for new technology

LCD Reconsiderations

Contact the Medical Policy Unit at NGS.LCD.reconsideration@anthem.com for questions concerning reconsideration of an active LCD.

Commenting on Draft LCDs

When draft LCDs are available, comments can be made by viewing drafts on the Medicare Coverage Database and selecting the ‘Draft Contact’ email link at the end of the LCD. Comments will only be considered if submitted during the formal comment period. Please send all draft comments to PartBLCDComments@anthem.com.

-Or-

National Government Services, Inc.
LCD Comments
P.O. Box 7108
Indianapolis, IN 46207-7108

Contractor Medical Director

Submit inquiries to the NGS CMDs at NGSCMD@anthem.com, only on clinical issues related to Medicare coverage.

Medical Policy

Please Note: General inquiries related to Medicare coverage policies, local and national coverage determinations, billing and reimbursement must be directed to the Provider Contact Center. The Medical Policy Unit contact information below is intended exclusively for IDE requests, LCD reconsiderations and the draft LCD comment process.

Investigational Device Exemption Requests

Contact the Medical Policy Unit at NGS-IDE-NewCoverage@wellpoint.com for questions about:

• • Investigational Device Exemptions (or to make IDE requests)
  • Coverage for new technology

LCD Reconsiderations

Contact the Medical Policy Unit at NGS.LCD.reconsideration@anthem.com for questions concerning reconsideration of an active LCD.

To make a reconsideration request, refer to the Local Coverage Determination Reconsideration Process—Medical Policy Article (A47355).

Commenting on Draft LCDs

When draft LCDs are available, comments can be made by viewing drafts on the Medicare Coverage Database and selecting the 'Draft Contact' email link at the end of the LCD.

Comments will only be considered if submitted during the formal comment period.

Please send all draft comments to PartBLCDComments@anthem.com

-Or-

National Government Services, Inc.
LCD Comments
P.O. Box 7108
Indianapolis, IN 46207-7108

Medical Policy

Please Note: General inquiries related to Medicare coverage policies, local and national coverage determinations, billing and reimbursement must be directed to the Provider Contact Center. Additional Medical Policy contact information is listed below.

Investigational Device Exemption Requests

Contact the Medical Policy Unit at NGSIDERequests@anthem.com for questions about:

• Investigational Device Exemptions (or to make IDE requests)
• Coverage for new technology

LCD Reconsiderations

Contact the Medical Policy Unit at NGS.LCD.reconsideration@anthem.com for questions concerning reconsideration of an active LCD.

To make a reconsideration request, refer to the Local Coverage Determination Reconsideration Process—Medical Policy Article (A47355).

Commenting on Draft LCDs

When draft LCDs are available, comments can be made by viewing drafts on the Medicare Coverage Database and selecting the 'Draft Contact' email link at the end of the LCD.

Comments will only be considered if submitted during the formal comment period.

Please send all draft comments to PartBLCDComments@anthem.com

-Or-

National Government Services, Inc.
LCD Comments
P.O. Box 7108
Indianapolis, IN 46207-7108

Contractor Medical Director

Submit inquiries to the NGS CMDs at NGSCMD@anthem.com, only on clinical issues related to Medicare coverage.

Audit and Reimbursement

Cost Report Filing

Provider Statistical and Reimbursement Report

Reimbursement

Cost Report Desk Reviews & Audits

Cost Report Appeals

Fiscal Intermediary Standard System/Direct Data Entry

DDE is a process that allows remote users online connectivity to the FISS, or mainframe, used by National Government Services to process Medicare claims. FISS/DDE connectivity will allow you to:

• • Enter UB-04 claims
  • Correct electronic claims that were submitted by batch mode, with the exception of MSP claims
  • Correct claims originally submitted on paper
  • Track all claims through the processing system
  • View the check number, date, and amount of your last three payments
  • View a variety of files for inquiry purposes, i.e., diagnosis codes, revenue codes and ANSI reason codes
  • Access the CWF via HIQA to find information on beneficiary entitlement, eligibility and other insurance

System Requirements

• • A Windows-based personal computer
  • A FISS/DDE logon ID and password, which are assigned by the NGS EDI Enrollment Department, by completing a Part A Logon Request Form
  • Connectivity to FISS/DDE only via a network service vendor

Hours of Availability

• • 5:00 a.m.–8:00 p.m. CT, Monday–Friday
  • 6:00 a.m.–9:00 p.m. ET, Monday–Friday
  • 3:00 a.m.–6:00 p.m. PT, Monday–Friday

Saturday Hours

• • 5:00 a.m.–2:00 p.m. CT
  • 6:00 a.m.–3:00 p.m. ET
  • 3:00 a.m.–12:00 p.m. PT

Contact Information/Support

• • Accessibility/login questions should be directed to the EDI Help Desk 
  • All other questions should be directed to the Provider Contact Center

Related Content

• • The web-based training courses are available at Medicare University
  • Fiscal Intermediary Standard System/Direct Data Entry Provider Online Manual

Fiscal Intermediary Standard System/Direct Data Entry

DDE is a process that allows remote users online connectivity to the FISS, or mainframe, used by National Government Services to process Medicare claims. FISS/DDE connectivity will allow you to:

• • Enter UB-04 claims
  • Correct electronic claims that were submitted by batch mode with the exception of MSP claims
  • Correct claims originally submitted on paper
  • Track all claims through the processing system
  • View the check number, date and amount of your last three payments
  • View a variety of files for inquiry purposes, i.e., diagnosis codes, revenue codes and ANSI reason codes
  • Access the CWF via HIQA to find information on beneficiary entitlement, eligibility and other insurance

System Requirements

• • A Windows-based personal computer
  • A FISS Logon ID and Password, which are assigned by the NGS EDI Enrollment Department, by completing a Part A Logon Request Form
  • Connectivity to FISS only via a network service vendor

Hours of Availability

• • 5:00 a.m.–8:00 p.m. CT, Monday–Friday
  • 6:00 a.m.–9:00 p.m. ET, Monday–Friday
  • 3:00 a.m.–6:00 p.m. PT, Monday–Friday

Saturday Hours

• • 5:00 a.m.–2:00 p.m. CT
  • 6:00 a.m.–3:00 p.m. ET
  • 3:00 a.m.–12:00 p.m. PT

Contact Information/Support

• • Accessibility/login questions should be directed to the EDI Help Desk 
  • All other questions should be directed to the Provider Contact Center

Related Content

• • Fiscal Intermediary Standard System/Direct Data Entry Provider Online Manual

Fiscal Intermediary Standard System/Direct Data Entry

DDE is a process that allows remote users online connectivity to the FISS, or mainframe, used by National Government Services to process Medicare claims. FISS/DDE connectivity will allow you to do the following:

• • Enter UB-04 claims
  • Correct electronic claims that were submitted by batch mode
  • Correct claims originally submitted on paper
  • Track all claims through the processing system
  • View the check number, date and amount of your last three payments
  • View a variety of files for inquiry purposes, i.e., diagnosis codes, revenue codes and ANSI reason codes
  • Access the CWF via HIQA to find information on beneficiary entitlement, eligibility and other insurance.

System Requirements

• • A Windows-based personal computer
  • A voice grade telephone line
  • A modem capable of operating at a baud rate of 33.6 KBs or higher
  • A FISS logon ID and Password, assigned by the NGS EDI enrollment department, for each user who needs online access
  • Connectivity to FISS via a network service vendor

Hours of Availability

• • 5:00 a.m.–8:00 p.m. CT, Monday–Friday
  • 6:00 a.m.–9:00 p.m. ET, Monday–Friday
  • 3:00 a.m.–6:00 p.m. PT, Monday–Friday

Saturday Hours

• • 5:00 a.m.–2:00 p.m. CT
  • 6:00 a.m.–3:00 p.m. ET
  • 3:00 a.m.–12:00 p.m. PT

Contact Information and Support

• • Accessibility/login questions should be directed to the EDI Help Desk 
  • All other questions should be directed to the Provider Contact Center

Corporate Holiday Schedule

The National Government Services Provider Contact Centers will be closed in 2019 to observe the following corporate holidays:

Audit and Reimbursement

Cost Report Filing

Provider Statistical and Reimbursement Report

Reimbursement

Cost Report Desk Reviews & Audits

Reopenings

Cost Report Appeals

Hospice Cap

Provider-Based Attestations

Provider Outreach and Education/Comprehensive Error Rate Testing

National Government Services

Toll Free Line

All Regions: For further information please contact the Provider Contact Center (PCC) located under Contact Us.

Email

All Regions: For further information please contact the PCC located under Contact Us.

CERT Documentation Center

Record Submission

(CID number on CERT record request, cover sheet, or bar-coded cover sheet)

Preferred methods: Electronic or Fax

Providers using secure gateway “esMD” may submit records by designating CERT.

Fax: 804-261-8100

Mail option:

CERT Documentation Center
1510 East Parham Rd.
Henrico, VA 23228

Option to Mail Medical Records on CD

Providers submitting documentation via CD should send the password to certmail@admedcorp.com; use the CID number in the subject line of your email (no PHI). 

Note: There is no need for the provider to encrypt the email. Following this procedure will ensure there is no delay in processing the documentation.

Update Your Provider Contact Information

Toll-Free: 888-779-7477 or 443-663-2699

CERT Website

https://certprovider.admedcorp.com/