Eli's Hospice Insider

Published on Fri Aug 16, 2013 PDF

If you’ve been ignoring HETS, it may be time to pay attention.

By April 2014, the Centers for Medicare & Medicaid Services plans to terminate access to Common Working File eligibility queries in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) — in other words, the HIQA, HIQH, ELGA and ELGH screens and HUQA.

Do this: “If you currently use CWF queries to obtain Medicare health insurance eligibility information for Medicare fee-for service patients, you should immediately begin transitioning to the Medicare Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS),” urges CMS in a newly updated MLN Matters article.

The problem is, HETS currently doesn’t return hospice benefit period information in the same way that the other CWF screens do. CMS plans to fix that problem by next April, it pledges.

HETS does provide a bene’s Part D plan number, address and enrollment dates; and Medicare Advantage Organization name, address, website and phone number, however, CMS says.