In conducting the review, the Council applied the framework for an activities-based approach described in the interpretive guidance on nonbank financial company determinations issued by the Council in December 2019. The Council’s review focused in particular on the activities of Fannie Mae and Freddie Mac (the Enterprises). Humana has committed to removing co-payments on Medicare Advantage telehealth visits through 2021.WASHINGTON – The Financial Stability Oversight Council (Council) today voted unanimously to approve a statement summarizing its review of the secondary mortgage market. It offers extra benefits on many plans, including dental, vision, and fitness benefits. Humana offers Medicare plans in every state. Humana offers many types of Medicare coverage. Consider Humana, one of the largest Medicare Advantage plans with availability in 84% of U.S. If you’re looking for Medicare coverage, CGS is not an option it does not offer health plans you can choose. CostĬGS processes claims according to Medicare fee schedules for the relevant services. The Better Business Bureau in CGS’s home state of Tennessee reports no customer complaints or reviews, and gives CGS an A+ rating. These CMS assessments provide oversight and accountability to the MACs. Average compliance in Fiscal Year 2019 was 93% compliance in the jurisdictions CGS operates in was above 90%. Third-Party RatingsĬMS evaluates MACs on dozens of compliance measures and publishes those results in overall reports by jurisdiction. However, CMS publishes overall average results by year, but does not publish individual contractor performance.ĬGS does not directly offer customer service for Medicare enrollees, but works directly with providers and suppliers who service people on Medicare. EST, Monday through FridayĬMS assesses each MAC based on factors such as customer satisfaction with the MAC website, provider enrollment, financial management, claims processing, appeals, and beneficiary customer service. EST, Monday through FridayĬustomer Service: 87, 9 a.m. EST, Monday through FridayĬustomer Service: 86, 8 a.m. Providers submit home health and hospice claims to the MAC covering the geography where the provider is physically located.Įach CGS contract area has its own customer service phone number and online access.Ĭustomer Service: 86, 8 a.m. Providers submit Part A and B claims to the MAC covering the geography where the provider is physically located.ĬGS processes home health and hospice claims. Suppliers submit claims to the MAC covering the geographic territory where the Medicare beneficiary lives.ĬGS provides customer service and processes claims for Medicare Parts A and B covered services. Depending on the service, there are up to five levels of appeal.ĬGS doesn’t sell Medicare insurance but provides administrative services on behalf of CMS.ĭurable Medical Equipment (DME) Medicare Administrative Contractor (MAC):ĬGS processes claims for DME, orthotics, and prosthetics and provides service to the suppliers of those products. CGS processes claims, which also means it decides whether to approve or deny claims according to Medicare rules and guidelines.

It provides support for providers who serve Medicare beneficiaries. It does not directly serve consumers but directs people to contact Medicare with any issues or complaints.ĬGS doesn’t offer Medicare insurance plans or services for consumers. It is not an option for people looking for Medicare insurance. Does not offer Medicare insurance plans: CGS is an administrative contractor that provides claims processing and service on behalf of CMS.

No reported customer complaints: A search of the Better Business Bureau and Consumer Financial Protection Bureau sites turns up zero complaints against CGS.

High level of compliance with Medicare standards: CMS’ evaluation of its administrative contracts in jurisdictions where CGS operates were all above 90%, including 95% and 94% in jurisdictions B and C, respectively.

Extensive geography and services: Operates in 38 states and holds multiple Medicare Administrative Contracts (MAC).

Oversight for mac review