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Wednesday, March 27, 2019 - 12:16

Eligibility discontinued on CWF

 

In December 2012, CMS announced plans to discontinue the Common Working File (CWF) beneficiary health insurance eligibility transactions (MLN Matters® Special Edition Article SE1249).  In that same article, CMS also announced the HIPAA Eligibility Transaction System (HETS) would be the single source for this data. CMS subsequently delayed this effort based on feedback about the differences in data returned between the two systems and the one-year limit to HETS historical search capability. CMS resolved these issues and is moving forward to phase-out the CWF beneficiary health insurance eligibility transactions. This will address inefficiencies of maintaining two different systems returning the same data.


Beginning in the fall of 2019, CMS plans to terminate access to CWF eligibility queries for those who already utilize HETS. If you currently use both CWF and HETS to get Medicare beneficiary health insurance eligibility information, you should immediately begin to use HETS exclusively.

 

If you need assistance setting up your HETS access for eligibility inquiries, get started today by contacting your ClaimShuttle Support Team at (602) 439-2525 option 1

Tuesday, October 10, 2017 - 11:36

Jurisdiction J Changes

On September 7, 2017, the Centers for Medicare & Medicaid Services (CMS) awarded Palmetto GBA (Palmetto) a new contract for the administration of Medicare Part A and Part B Fee-for-Service (FFS) claims in the states of Alabama, Georgia, and Tennessee (A/B MAC Jurisdiction J). CMS will oversee the transfer of A/B MAC work from the incumbent contractor, Cahaba Government Benefit Administrators, LLC, to Palmetto over the next several months. CMS anticipates that implementation of the new contract will go smoothly, with few, if any, service issues for Medicare beneficiaries and providers.

The official cut over for Part A submitters is scheduled for 1/29/18
The official cut over for Part B submitters is scheduled for 2/26/18

For more information about this award, you may click here

You should also read Palmetto's JJ Transition page here

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