Healthcare Provider Solutions

Home Care and hospice providers usually rely on the Medicare DDE system or their software systems for Medicare eligibility verifications. Some agencies leverage their relationship with various network service vendors to verify eligibility. Most agencies receive their remittance advices electronically, either directly, through a network service vendor, or through their software vendor. What many providers do not know is that each one of the Medicare Administrative Contractors (MACs) has web-based provider portals available that allow for secure eligibility verifications, retrievals of copies of Medicare remittance advices and many other features. It’s good to have a back-up available when Medicare announces “Dark Days” for the Common Working File (CWF). Dark days are times when the Medicare eligibility system and even claims processing is briefly interrupted during which Medicare applies updates to their systems. A couple of these Dark Days are on the near horizon, scheduled for July 2nd, 3rd, and 4th. Is your agency ready with an alternative? If you have ever had to use one of the Interactive Voice Response (IVR) systems your staff will thank you for getting and keeping this attractive alternative to the telephone available to them as a back-up.

Palmetto GBA

Palmetto GBA’s web portal service is Online Provider Services (OPS). OPS boasts such features as Eligibility, Claim Status, Financial information such as check history and payment floor information, remittance advice copies, and much more. Click the link below to learn more and to register as a Palmetto GBA OPS user.

Online Provider Services (OPS)

CGS Medicare (CGS)

For CGS the web portal is called MY CGS. Like Palmetto, a My CGS login will give users access to eligibility features, remittance advice copies and other financial information and much more. Click the link below to learn more and to register as a MY CGS user.

MY CGS

National Government Services (NGS)

The NGS web based portal is called NGSConnex and like the others, provides eligibility information, remittance advice copies and other financial information, claim status inquires, and allows for electronic submission of appeals/redetermination requests with attachments. Click the link below to learn more and to register as a NGSConnex user.

NGSConnex

The enrollment criteria differs slightly for each of these sites so follow the links above to get all the information you need to become a registered web portal user. Creating an account does not take long. Once these accounts are set up, users must regularly login to keep the account active, so it is available when needed.