If you query Medicare’s common working file (CWF) to obtain eligibility information about Medicare patients, you should immediately begin transitioning to the Medicare HIPAA Eligibility Transaction System (HETS).
In April, the Centers for Medicare & Medicaid Services (CMS) plans to discontinue access to the CWF queries through its various shared systems. However, you can receive patient eligibility information from HETS, which has been around since 2005. To learn how to access HETS, refer to the CMS HETS Help webpage.
This change will not affect the use of Medicare’s Direct Data Entry system to submit claims or to correct claims, nor will it affect access to beneficiary eligibility information from Novitas’ Interactive Voice Response system at (855) 252-8782.
For more information, including frequently asked questions about HETS, read CMS’ MLN Matters No. SE1249 (PDF).
Published March 26, 2013
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