UPDATED: January 19, 2010
Supplier Interactive Voice Response (IVR) System
CIGNA Government Services DME MAC Jurisdiction C has an Interactive Voice Response (IVR) System at 866.238.9650 with multiple options to assist you. The IVR is available 24 hours a day, 7 days a week with the exception of system upgrades or routine maintenance. The IVR menu options that require system access are available Monday - Friday 6:00 AM - 8:00 PM and Saturday 6:00 AM - 4:00 PM Central Time (please note that some options which access the Common Working Files may have shorter availability).
The IVR offers information regarding claim status, pending claims, Redetermination status, beneficiary eligibility, Certificate of Medical Necessity (CMN) status for same or similar equipment inquiries, SNF/Inpatient hospital stay information, hospice information, pricing, outstanding checks, the last 5 checks issued, offsets and EFT application status. It also offers some general information, such as customer service hours of operation. Our customer service representatives are available at 866.270.4909 Monday - Friday from 7:00 AM - 5:00 PM Central Time, for inquiries that cannot be handled through the IVR.
Current features of the IVR:
Option 1 - Claim Information
Press 1 - Claim Status Inquiry (pending, on the payment floor, denied, paid and/or applied to deductible)
- Line by line explanation of the payment/denial
- Expected payment amount and check date for claim on the payment floor
- Appeal rights on denied claims
- Multiple Medicare numbers
- Multiple NPI numbers
Press 2 - Pending claim Information
- Payment Floor Information
- Total number of claims
- Total submitted amount
- Total expected payment
- Pending claims at CWF
- Total number of claims
- Total submitted amount
- Other Pending Claim
- Total number of claims
- Total submitted amount
Press 3 - Redetermination Status (pending, reversed, partially reversed, upheld or dismissed.)
Press 4 - To order a duplicate remittance notice
Option 2 - Beneficiary Information
Press 1 - Beneficiary Medicare Eligibility Information
- Part A entitlement date
- Part B entitlement date
- Medicare Advantage Plan enrollment information
- Home Health information
- Medicare Secondary Payer information
Press 2 - Beneficiary Part B Deductible
- Amount of deductible remaining for the current calendar year
- Amount of deductible remaining to the previous calendar year
Press 3 - CMN Status
- Initial, recert or revision date
- Length of need
- Previous supplier's phone number for rented items
- Last date billed for rented items
- Total months paid for rented items.
Press 4 - SNF/Inpatient Hospital Stay
- If SNF or Inpatient hospital facility claim on file for the date of service entered
- The NPI of the facility and the Web site address for NPPES for inpatient claims
- The admission date
- Type of discharge and date of discharge
Press 5 - Hospice Information
- Start and end date of the most current Hospice episode
Option 3 - Payment Information
Press 1 - Pricing
Press 2 - Check information
- Outstanding Check Information
- Check date
- Check amount
- Last 5 Checks Issued
- Check date
- Check amount
Press 3 - Offset information
- Claim details of original overpayment
- Original overpayment letter date and current offset balance
Press 4 - EFT Application Status (pending, approved, rejected and the reason why it is rejected.)
Option 4 General information
Press 1 - Information on your Appeal Rights
Press 2 - Customer Service hours of operation
There is no limit to the number of claims you can check in the IVR!!
Below are some quick tips on accessing information through the IVR:
To enter a Provider Transaction Access Number (PTAN), formerly known as your supplier number:
If the PTAN contains a letter, press 1. Enter the PTAN excluding the C followed by the "#" key.
If the PTAN does not contain a letter, press 2. Enter the 10-digit number followed by the "#" key.
The IVR will repeat the number entered. Press 1 if the number entered is correct. If you would like to reenter the number, press 2.
To enter a beneficiary's Medicare number:
If the Medicare number begins with a letter, press 1. Then,
- If the prefix letter is A, press 1.
- If the prefix letters are CA, press 2
- If the prefix letters are MA, press 3.
- If the prefix letters are PA, press 4.
- If the prefix letters are WA, press 5.
- If the prefix letters are WD, press 6.
- If the prefix letters are WCA, press 7.
- If the prefix letters are WCD, press 8
If it is any other letter(s) press 9
- If the prefix letter is H, press 1
- If the prefix letters are JA, press 2
- If the prefix letters are MH, press 3
- If the prefix letters are PD, press 4
- If the prefix letters are PH, press 5
- If the prefix letters are WH, press 6
- If the prefix letters are WCH, press 7
Enter the 6 or 9 numbers following the prefix followed by the # key.
If the Medicare number begins with a number, press 2. Then,
Enter the nine-digit Medicare number.
The system will then prompt you to enter the alpha character at the end of the Medicare number.
- If the letter is A, press 1.
- If the letter is B, press 2.
- If the letter is C, press 3.
- If the letter is D, press 4.
- If the letter is M, press 5.
- If the letter is T, press 6.
- If the letter is W, press 7.
- If it is any other letter(s) press 8
If it is any other letter(s) press 9
- If the prefix letter is H, press 1
- If the prefix letters are JA, press 2
- If the prefix letters are MH, press 3
- If the prefix letters are PD, press 4
- If the prefix letters are PH, press 5
- If the prefix letters are WH, press 6
- If the prefix letters are WCH, press 7
Enter the 6 or 9 numbers following the prefix followed by the # key.
If the Medicare number begins with a number, press 2. Then,
Enter the nine-digit Medicare number.
The system will then prompt you to enter the alpha character at the end of the Medicare number.
- If the letter is A, press 1.
- If the letter is B, press 2.
- If the letter is C, press 3.
- If the letter is D, press 4.
- If the letter is M, press 5.
- If the letter is T, press 6.
- If the letter is W, press 7.
- If it is any other letter(s) press 8
- To enter a letter you will need to press 2 keys. Press the key that contains the letter on your telephone key pad. Then press 1, 2 or 3 depending on the position of the letter on the telephone key pad ( i.e., to enter the letter A press 2 1). Assume letters Q and Z are located on the 1 key. The Q is in the first position and the Z is in the second position (i.e., to enter the letter Z press 1 2).
If the letter is followed by a number, press 1. If the letter is followed by another letter, press 2. If no number or letter follows the letter, press the "#" key.
To enter a date of service, use MM/DD/YY format (e.g., 010107).
To enter a FCN number:
Enter the first 11 digits of the FCN number followed by
the "#" key.
To enter the beneficiary's first initial
Enter the beneficiary's first initial by using the letters
on your telephone keypad (i.e., for A enter 2).
To enter the beneficiary's last name:
Enter the first six letters of the beneficiary's last
name by using the letters on your telephone keypad followed by
the # key (i.e., for Smith enter 76484#). Include any suffixes,
such as 'Jr.' or 'III' if included in first 6 letters (i.e., for
Smith Jr. enter 764845#). Exclude any special characters, such
as 'hyphen' or 'apostrophe'.
The corresponding letters of the telephone keypad numbers are:
- If the letter is A, B or C, enter 2
- If the letter is D, E or F, enter 3
- If the letter is G, H, or I, enter 4
- If the letter is J, K, or L, enter 5
- If the letter is M, N or O, enter 6
- If the letter is P, Q, R or S, enter 7
- If the letter is T, U or V, enter 8
- If the letter is W, X, Y or Z, enter 9
Claim Information (Option 1)
For claim Status, press 1 - To receive claim status you must enter your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number and name and the date of service. (See instructions above on entering this information.) After getting the status of a claim, you may choose from the following:
- For line by line information on the claim, press 1. ( appeal rights and denial information on non-covered claims will be given)
- To continue, press 2.
- To order a duplicate remittance notice on the claim, press 1.
- To continue, press 2.
- To receive claim information on another claim for the same date of service, press 1.
- To receive claim information on this Medicare number for a different date of service, press 2.
- To receive claim information on a different Medicare number, press 3.
- To have this information repeated, press 7
- To return to the main menu, press 8.
- To receive information on a different PTAN, press 9.
For Pending Claim Information, press 2 - You will need to enter your NPI and PTAN and last five digits of tax identification number (TIN).
Press 1 and the total amount of claims, the total submitted amount and the total expected payment amount for the claims currently on the payment floor will be provided.
Press 2 and the total amount of claims and the total submitted amount for the claims pending at the Common Working File (CWF) will be provided.
Press 3 and the total amount of claims and the total submitted amount for other pending claims will be provided.
For Redetermination status, press 3 - To verify Redetermination status you must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, beneficiary's name, and the DCN from your Acknowledgement Letter. This option will provide the status of your Redetermination request including whether it is pending, reversed, partially reversed, upheld or dismissed.
For a duplicate Remittance Notice, press 4 - You will need your NPI, PTAN, last five digits of tax identification number (TIN), and the payment report date. (See instructions above on entering this information.) You will receive a duplicate remittance notice in the mail.
Beneficiary Information (Option 2)
For eligibility information, press 1 - To verify Medicare eligibility for a beneficiary you must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, date of birth and the beneficiary's name. This option will provide the Medicare Part A and B entitlement date and term date, if applicable.
Press 2 to verify if the beneficiary is enrolled in a Medicare Advantage Plan. This option will provide the name of the plan, the enrollment date and term date, if applicable, and the plan's contract number. Medicare Advantage plan addresses and phone numbers are available on the CMS Website.
Press 3 to verify if the beneficiary is in a home health episode. This option will provide the start and end date of the home health episode, if applicable. This option will also provide the NPI of the Home Health Agency and the Web site address for the NPPES Registry to obtain the agency’s name, address and phone number.
Press 4 to verify if there is a Medicare secondary payer record on file for the beneficiary. If so, you are instructed to contact the beneficiary for more information.
For deductible information, press 2 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, date of birth and the beneficiary's name. This option will provide the current and previous year deductible remaining for the Medicare number you entered.
For CMN status, press 3 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, the beneficiary's name and date of birth, and the procedure code. This option will provide CMN information on file for the procedure code entered and also CMN information on any similar equipment on file for a beneficiary. The IVR will provide the initial, recert or revision date, the length of need, the previous supplier's phone number, the last date billed and the total months paid for rented items. If there is more than one same or similar CMN on file for the procedure code entered, the IVR will prompt you to listen to all related CMNs.
For SNF/Inpatient Hospital stay information, press 4 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, date of birth, name and the date of service. This option will provide SNF/ Inpatient hospital information if a facility claim is on file for the date of service entered. The IVR will provide the NPI of the facility and the Web site address for NPPES if the beneficiary was still inpatient, the admission date, and the type and date of discharge if the beneficiary was discharged.
For Hospice information, press 5 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), the beneficiary's Medicare number, name and date of birth. The IVR will provide the start and end date of the most current Hospice episode on file.
Payment Information (Option 3)
For the Medicare allowed amount on a specific procedure code, press 1 - You must provide your NPI, PTAN, last five digits of tax identification number (TIN), specify the state where the beneficiary resides, and the HCPCS code and modifiers. The current Medicare allowed amount would be provided.
To enter letters for a state code:
- Using the letters on your touchtone telephone, enter the first letter of the state where the beneficiary resides. For example: If the beneficiary resides in Alabama, press the 2 key.
- Select the state desired by entering the number provided by the IVR. For example: For Alabama, press 1; for Arkansas, press 2; for Colorado, press 3 - (only the states serviced by Jurisdiction C will be available)
To enter the HCPCS code you're looking for.
- If the procedure code begins with an A, press 1
- If the procedure code begins with a B, press 2
- If the procedure code begins with an E, press 3
- If the procedure code begins with a K, press 4
- If the procedure code begins with a L, press 5
- If the procedure code begins with a J, press 6
- If the procedure code begins with a Q, press 7
- If the procedure code begins with a V, press 8
Enter the next 4 digits of the procedure code.
If there is a modifier at the end of the procedure code, press 1, otherwise press 2.
If the procedure code is followed by a modifier:
- If the modifier is NU, press 1
- If the modifier is RR, press 2
- If the modifier is UE, press 3
- If the modifier is KFRR, press 4
- If the modifier is KFNU, press 5
- If the modifier is KO, press 6
- If the modifier is KP, press 7
- If the modifier is KQ, press 8
- If the modifier is MS, press 9
For check information, press 2 - You will need to enter your NPI, PTAN, and the last five digits of your tax identification number (TIN).
Press 1 for the outstanding checks on file for the last month including the check date and check amount.
Press 2 for the last 5 checks issued to the PTAN entered. This includes the check date and check amount.
For offset information, press 3 - You will need to enter your NPI, PTAN, the last five digits of your tax identification number (TIN), and the FCN number located on your Medicare remittance notice. You will have the option to receive claim detail information on the original overpayment and/or the original overpayment letter date and current offset balance amount. The claim detail information includes the beneficiary's Medicare number, overpayment amount and dates of service for each claim involved in the original overpayment. Claim detail information is available for FCNs that contain 34 claims or less. If the FCN contains more than 34 claims, you may request a copy of the original overpayment letter by faxing your request to 615.782.4623.
For EFT application status, press 4 - You will need to enter your NPI, PTAN, and the last five digits of your tax identification number (TIN). This option will provide the status of your EFT application including whether it is pending, approved, rejected and the reason why it is rejected.
General Information (Option 4)
For information about your appeal rights, press 1 - Information about what services are eligible for a review, the elements that should be included in a review request and the proper party to a review is provided.
For customer service hours of operation, press 2 - The IVR provides the hours of operation and telephone number of the customer service line.
To repeat these choices, press 7
To return to the main menu, press 8
To get information about another NPI/PTAN, press 9
