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Terms of Use

The Terms of Use provide privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes (1) this computer network, (2) all computers connected to this network, and (3) all devices and storage media attached to this network or to a computer on this network.  

This system is for Government ­authorized use only.

Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties. 

Personal use of social media and networking sites on this system is limited as to not interfere with official work duties and is subject to monitoring. 

By using this system, you understand and consent to the following: 

• The Government may monitor, record, and audit your system usage, including usage of personal devices and email systems for official duties or to conduct HHS business. Therefore, you have no reasonable expectation of privacy regarding any communication or data transiting or stored on this system. At any time, and for any lawful Government purpose, the government may monitor, intercept, and search and seize any communication or data transiting or stored on this system.
• Any communication or data transiting or stored on this system may be disclosed or used for any lawful Government purpose. 

The Centers for Medicare and Medicaid Services (CMS) maintains ownership and responsibility for this computer system and allows CGS Administrators, LLC to provide the services. Users must adhere to CMS information security policies, standards, and procedures.

CGS Administrators, LLC reserves the right to change these terms of use from time to time. You agree that you shall be bound by the terms of use appearing on this site at the time you are using the site. By using myCGS, you agree to release CGS Administrators, LLC from any and all claims, liabilities or damages related to your use. You further agree to indemnify and hold CGS Administrators, LLC harmless, including the payment of attorney's fees, for any breach of this Agreement, negligence, violation of law, or willful conduct on your part in connection with the use of this system.

Use of Data and Information

CGS Administrators, LLC provides the information on myCGS free of charge and for informational purposes only. Although CGS Administrators, LLC attempts to ensure the content is correct and complete, you agree not to hold CGS Administrators, LLC responsible for the accuracy of this information, and you assume all the risks associated with its use. CGS Administrators, LLC may change, delete or update information without notice.

CGS Administrators, LLC has no obligation to update information within this site. This means information on the site may be out of date at any given time. CGS Administrators, LLC also may make improvements or changes in the products or services described on the site at any given time without notice.

You may print a copy of the information displayed on this site. However, CGS Administrators, LLC does not transfer or grant any intellectual property or other rights to you, including any copyright, trademark, service mark, or patent rights, which CGS Administrators, LLC expressly reserves for itself. You agree not to distribute, manipulate, create derivative works from, or use the information on this site for any purpose other than as expressly authorized by CGS Administrators, LLC.

Any copy and/or alteration of the original data displayed on this site, including conversion to other media or other data formats, is the responsibility of the requestor. Any data manipulated or reprocessed by the user is the user’s responsibility and may not present CMS or CGS Administrators, LLC data. CGS Administrators, LLC is not responsible for any converted, processed or otherwise altered data or assistance with converting the data to another format.

ALL MATERIALS ON THE SITE ARE PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESS OR IMPLIED. OWNER DISCLAIMS ANY AND ALL EXPRESS AND IMPLIED WARRANTIES, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT.

OWNER SHALL NOT BE LIABLE FOR ANY SPECIAL, INDIRECT, PUNITIVE, INCIDENTAL, OR CONSEQUENTIAL DAMAGES, INCLUDING WITHOUT LIMITATION, LOST REVENUES OR LOST PROFITS, WHICH MAY RESULT FROM THE USE OF THESE MATERIALS.

Use of Beneficiary Data

CGS Administrators, LLC is obligated by the Federal Privacy Act, 5 U.S.C. Section. 552a and the HIPAA Privacy Rule, 45 C.F.R Parts 160 and 164, to protect the privacy of individual beneficiaries and other persons. By signing this agreement, the user agrees not to use CGS Administrators, LLC or CMS data to determine the identity of individual persons. Attempts to determine individual identities from public data is a violation of the federal Privacy Act, 5 U.S.C and the HIPAA Privacy Rule.

myCGS may be used to verify, not determine, Medicare beneficiary eligibility. Unauthorized transactions include attempting to acquire the Medicare beneficiary's Medicare ID when it is not known, and determining eligibility for Medicare, without first screening the patient. Proper usage of the MBI Lookup Tool is not considered an unauthorized transaction.

By using the eligibility function in the portal, you are also agreeing to your understanding of and adherence to CMS's HETS Rules of Behavior.

Scope and Authority of Use

By registering, you represent to us that you have the proper authority to use myCGS on behalf of yourself, any organization you represent, and/or any other person or entity you represent.

You agree to not access, use, or disclose any information obtained from this Website in a manner that may be unauthorized, unlawful, or beyond the specific purpose for which such information is made available, nor will you permit or enable others to do so.

Claim Submission/Remittances

By registering to use myCGS, you authorize myCGS/CGS Administrators, LLC to send electronic claim submissions and receive electronic response reports on your behalf. Additionally, you authorize myCGS/CGS Administrators, LLC to only provide electronic remittances going forward. By submitting a claim via myCGS, you understand that your processed Medicare claim will contain payment information and agree that you are authorized to endorse this access on behalf of your company.

Any 'documents' the user retrieves via the myCGS e-Remittance feature are EXACT copies/facsimiles of the print version that can be viewed in the presented format, downloaded, and/or printed.

Secure Form Submission

Secure forms successfully submitted via myCGS will automatically generate inbox messages containing important information about the secure form submissions. The first message advises the user of the submission of the form in myCGS and contains a transaction ID. Within 24 hours of receiving this message, excluding weekends and holidays, the user should receive a second confirmation message that contains the official date of receipt by CGS and the DCN for this form submission.

Green Mail

By selecting to receive any of the specified letters electronically via CGS’s “Green Mail” process, I hereby agree that I have the authority to make this decision on behalf of my NPI and/or PTAN. I understand that by making this selection, I am now the only person associated with this NPI and/or PTAN that can change this selection. I understand that by selecting this option I may be automatically signed up for all letter types available for my NPI and/or PTAN in the future.

I understand this consent is effective until further notice by CGS or until I withdraw it by returning to the myCGS portal and changing my NPI and/or PTAN preferences. If I withdraw my consent to Green Mail, I understand you will resume delivery by U.S. Mail for the selected Electronic Document(s) within seven (7) days of the update. If my account is inactivated for any reason, this selection will remain as-is and “open” to other provider administrators for modification.

I understand Green Mail will be provided in Portable Document Format (PDF) and that I must have Adobe® Acrobat® viewer software installed on my computer to view these documents. I understand if I do not have the ability to access and retain PDF documents, I should not consent to Green Mail.

I understand that, from time to time, email notifications may not transmit properly and that it is my responsibility to log into myCGS and check my message inbox for mail.

Any 'documents' delivered, accepted, and retrieved by the user via myCGS Green Mail are EXACT copies/facsimiles of the print version that can either be viewed in the presented format, downloaded, and/or printed at the user’s option.

Roles and Responsibilities

CGS allows users to create login IDs in the myCGS portal. This requires the initial user login creation, followed by the registration process for each provider PTAN/NPI combination. This initial user will be listed as a provider administrator for this account. Users can request access to existing provider PTAN/NPI combinations and are approved by the administrator.  

Provider administrators are granted permission to all functions of the application. The provider administrator grants access for all subsequent users to access, view, and print from this website the information related to said provider. Users can request changes to permissions granted by the provider administrator. If, during the 5-day request window, no action is taken by the provider administrator, then no changes will occur.

Provider administrators are responsible for maintaining access for the account and reviewing all accounts at least every 360 days to ensure that each user's access is still appropriate.

This includes the following:

• Creating and/or approving provider users
• Creating and/or approving additional provider administrators
• Assigning a temporary password to the provider users when needed
• Assigning and/or approving application permissions to the provider users
• Terminating user access
• Terminating additional provider administrator access
• Changing the provider administrator
• Recertifying user and administrator access
• Unlocking users or additional provider administrators who have locked out their user ID due to entering incorrect passwords.

Any access granted and maintained by the provider administrator is the sole responsibility of that provider administrator. CGS Administrators, LLC has no responsibility for maintaining provider user access and permission to the data assigned to them by the provider administrator. The provider user can access information as granted by the provider administrator and must work through their provider administrator to resolve any access issues.

Each user of myCGS must have a unique user ID and password. Generic contact (user) names are not permitted. This means that we expect each user to have a legitimate first and last name associated with each user ID. Examples of generic user names are: Front Desk, Account Coordinator, Billing Department, User A, or the name of your provider office. No sharing of user IDs and passwords is permitted. CGS Administrators, LLC will delete, without notice, any user names we find that are generic.

CGS Administrators, LLC has the right to terminate any user's access if suspicious or improper activity is determined.

Protect Your Password

All user accounts must have passwords because the password is a means to authenticate the identity of the person using an account as the authorized user and to prevent misuse by unauthorized users.

Passwords are case sensitive and must compy with the latest minimum acceptable password requirements.

More secure password information can be found below in the 'Passwords' section under 'Rules of Behavior'.

Do not leave the system accessible on your computer when you are away from the computer. Remember to log off and close your browser each and every time you exit the system.

Recertification of Access

myCGS requires that all users, including provider administrators, periodically update their profile. In addition to the profile verification process, provider administrators must also recertify provider users, and additional provider administrators, who have access to myCGS for the same PTAN/NPI combination. Non-compliance with the recertification process by the provider administrator or the provider user will result in denial of access to myCGS. CGS reserves the right to request that users recertify access at any time. CGS has the right to deny recertification and terminate any user's access if suspicious or improper activity is determined.

Automated Interfaces

The use of any application, program, or macro (among other examples) that interfaces with myCGS is prohibited. myCGS is a stand-alone portal and shall only be used "as is" by the user.

Medicare Information Databases

Users are not authorized to use the myCGS eligibility and claim status functions to create non-CMS controlled Medicare databases. Users cannot create and host local Medicare eligibility and claim status databases that replicate the functionality of myCGS.

Cookies

We may use "cookies" or similar technologies in order to track usage of myCGS and help us in improving our services. Most Internet browsers allow you to erase cookies from your hard drive, block all cookies, or receive a warning before a cookie is stored. Please refer to your Internet browser's help files or user guides to learn more about these functions.

Contacting Us

When sending myCGS feedback through the Contact Us section of myCGS, please do not transmit any of the following information to CGS Administrators, LLC. Revealing this information online could expose you or others as a target for Medicare fraud and abuse.

• Personal information, including Social Security numbers.
• Beneficiary information, including Medicare IDs, coinsurance and deductible information, dates of Medicare entitlement, copies of or information from Medicare claim forms, Medicare reports of eligibility, and Medicare Summary Notices (MSNs).
• Information covered under the Freedom of Information Act (1967) and/or the Privacy Act of 1974.
• Claim specific data.

The Contact Us form is for feedback only. If you need assistance with the myCGS application, you must call the Level 1 Triage Support at 866-590-6703.

Basic Security & Privacy Awareness Training

By signing this agreement, the user acknowledges they are aware of and have participated in basic security and privacy awareness training both prior to initial use of the myCGS system and annually thereafter.

Rules of Behavior

Compliance with Security & Privacy Policies

• I understand and accept responsibility for company security and privacy policies and rules of behavior
• I understand that violation of laws, such as the Privacy Act of 1974, copyright law, and 18 USC 2071, can result in monetary fines and/or criminal charges that may result in imprisonment
• I certify that I have not been sanctioned, reprimanded, excluded, debarred, or otherwise disciplined in connection with participation in any federal program
• I understand that I may be granted access to U.S. Government information systems, and that such access is provided for U.S. Government-authorized use only. I realize that I have no reasonable expectation of privacy regarding any communication or data that I transmit or store on these information systems; and that for any lawful U.S. Government purpose, my activities on these information systems may be monitored, intercepted, and searched.
• If I have knowledge of a security incident and fail to report it, I understand that I will share in the responsibility for the outcome and any consequences or actions that may arise
• I will immediately report known or suspected disclosures or system problems that could lead to the unauthorized disclosure of confidential/sensitive information to the EDI Help Desk and my supervisor and/or my business unit's Systems Security Officer or Privacy Official
• I will not direct or encourage others to violate policies
• I will not use company resources for personal gain

Confidential/Sensitive Information

• I am aware that I am responsible for learning and understanding how to recognize and identify confidential/sensitive information
• I will only access confidential/sensitive information as required to perform my assigned job functions (i.e., a need-to-know basis). I will never attempt to access files or information for which I am not expressly authorized to view.
• I will not share confidential/sensitive information with anyone who does not have a valid business need-to-know, such as family or friends
• I will not copy or duplicate information and data, whether confidential/sensitive in nature or not, unless required in support of a business-related responsibility or function. I will never knowingly or willingly conceal, remove, mutilate, obliterate, falsify or destroy information in an improper/unapproved manner. I understand that I am not permitted to use company or customer information for non-business or personal purposes.
• Whenever appropriate, I will mark documents containing confidential/sensitive information FOR OFFICIAL USE ONLY to alert readers to the confidential/sensitive nature of this information. I will include an approved confidentiality stamp on all non-public documents that I create.
• I understand that confidential/sensitive paper documents must be stored in a secure manner when not in use, when I am away from my desk, and after normal working hours. I will secure documents or forms containing confidential/sensitive information in a manner that prevents unauthorized or inadvertent viewing whenever I am not using them or when visitors are present.
• I will dispose of unneeded or end-of-life paper documents using the company-approved methods
• I understand that electronic media should not be discarded except in approved e-media shredding bins or as otherwise directed by company security policies
• I will not duplicate information or data protected by a copyright law without documented approval from management, the manufacturer, licensee or applicable site license agreement
• I understand that removable electronic media, such as USB portable flash memory devices (jump drives/thumb drives) and optical discs (DVD-ROM, CD-ROM, etc.), containing PHI/PII or confidential/sensitive information must be encrypted using company-approved encryption methods

Passwords

• I will not disclose my password to anyone, whether in person or on the phone. This includes my manager, coworkers, auditors, the help desk, technical support, system administrators, CMS, visitors, family, friends, etc. There are no exceptions.
• I will not write down my passwords, automate their entry in macros or scripts, or store them in a computer file. I will protect them as I would the most confidential/sensitive information. I will not share or sign someone else onto a system with my ID or password.
• I will change my password when the system requires it or when I initiate it only. I understand that the help desk will not call me or email me requesting that I change my password.
• When creating a password, I will not use common words found in the dictionary; names of family, pets or sports teams; dates of birth; or other identifiable phrases associated with me
• When creating a password, I will not use letters or numbers that are near each other on the keyboard (ex. hjkl) or appear in a logical sequence (ex. 123456 or abcdefg)

LICENSES AND NOTICES End User Point and Click Agreement

CPT codes, descriptions and other data only are copyright 2012 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials (web pages, PDF documents, Excel documents, Word documents, text files, Power Point presentations and/or any Flash media) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt.

Applicable FARS/DFARS restrictions apply to government use.

U.S. Government Rights

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)(June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities

CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third-party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End users do not act for or on behalf of CMS. THE CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. THE CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

Should the foregoing terms of use be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled “I Accept.”

LICENSE FOR USE OF “DENTAL PROCEDURE CODES” (CPT) FOURTH EDITION End User Point and Click Agreement

These materials contain Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2012 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS OF USE CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED “I ACCEPT”, YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS OF USE SET FORTH IN THIS AGREEMENT.

IF YOU DO NOT AGREE WITH ALL TERMS OF USE SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED “I DO NOT ACCEPT” AND EXIT FROM THIS COMPUTER SCREEN. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, “YOU” AND “YOUR” REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

1. Subject to the terms of use contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association website, http://www.ada.org/.
3. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions apply to government use. U.S. Government Rights. This product includes CDT, which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Dental Association, 211 East Chicago Avenue, Chicago, Illinois, 60611. U.S. government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
4. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT and other content contained therein, is with CGS or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third-party beneficiary to this Agreement.
5. CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

The license granted herein is expressly conditioned upon your acceptance of all terms of use contained in this agreement. If the foregoing terms of use are acceptable to you, please indicate your agreement by clicking below on the button labeled “I AGREE”. If you do not agree to the terms of use, you may not access or use the software. Instead, you must NOT click below on the button labeled “I AGREE” and exit from this computer screen.

By signing this agreement, the user acknowledges they understand and accept responsibility for all of the Terms of Use and Conditions, including the Rules of Behavior, identified in this material.

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