CWF will Implement Auto-search for Beneficiary Eligibility Queries in January 2017
August 4, 2016 11:23 AM
On July 29, 2016, the Centers for Medicare & Medicaid Services (CMS) issued Change Request 9740/Transmittal 1687 (MM9740) to implement an auto-search capability for provider beneficiary eligibility queries to the Common Working File (CWF); this change will become effective January 1, 2017.
Currently, each beneficiary is assigned to one of nine CWF hosts based on the location where the beneficiary signed up for Social Security benefits. If the provider does not know which of the CWF hosts to query for the beneficiary’s eligibility information, the provider may need to make as many as nine queries to the system in order to obtain that information.
CMS has developed a systems change that will link the CWF hosts together and allow for a single query to search across multiple CWF host systems to locate the beneficiary information. For those providers that currently utilize ELGA, HIQA, ELGH, HIQH, or HUQA queries to the CWF, this change will save time and likely reduce the number of queries that must be made to access beneficiary eligibility information. Those providers who utilize the HIPAA Eligibility Transaction System (HETS) for beneficiary eligibility queries will be unaffected by this change.