Home Health & Hospice Week

Industry Note:

Move Your Eligibility Search To HETS

It soon will be time to change your procedures, if you use the Common Working File for beneficiary health insurance eligibility transactions for your hospice patients.

Why? “Beginning in the fall of 2019, CMS plans to terminate access to CWF eligibility queries for those who already utilize HETS,” the HIPAA Eligibility Transaction System, the Centers for Medicare & Medicaid Services says in a recently updated noticed. “If you currently use both CWF and HETS to get Medicare beneficiary health insurance eligibility information, you should immediately begin to use HETS exclusively.”

CMS originally had planned to make the switch this summer, but bumped the timeline to fall to resolve complaints “about the differences in data returned between the two systems and the one-year limit to HETS historical search capability,” the agency notes in the notice at www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp/MCARE-Notification-Archive-Items/MCARE20190327.html.

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