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September 28, 2015

October 2015 Release "Dark" Days for the Common Working File (CWF) Hosts

For the upcoming October 2015 release, there will be two "dark" days on Friday, October 2 and Saturday, October 3, 2015. This means that claims will not cycle to CWF on October 2 and 3. The next cycle to CWF will occur during the night, Monday October 5, 2015.

In addition, providers should be aware of the following:

  • Out of Service Area (OSA) responses will be dropped from September 28, 2015, through October 2, 2015. Claims processing delays will occur when a beneficiary’s record is located outside of the Great Western (GW) CWF Host site. Affected claims will begin to recycle to locate the beneficiary’s records on October 6, 2015; therefore, additional time may be required for claims to process and pay.
  • During the "dark days", October 2 and 3, 2015, ELGA and ELGH will not be available. While the CWF Dark Days will impact your access to ELGA and ELGH, it will not affect your ability to access beneficiary eligibility information through myCGS. In addition, the Interactive Voice Response (IVR) will be available.

We anticipate that claims will still be processed within the allowed timeframe. As a reminder, the Medicare Claims Processing Manual (Pub. 100-04, Ch. 1, § 80.2.1.1External PDF) states that Medicare contractors have 30 days to process clean claims. While the typical timeframe to process claims is less than this, contractors have the full 30 days from the receipt date of a clean claim to process it. Please note that home health Requests for Anticipated Payment (RAPs) and hospice Notice of Elections (NOEs) are not considered claims and thus, there is no specified timeframe for processing them. For additional information on the status of claims, refer to the "Checking Claim Status FAQs" on the CGS website.

Note for Hospice Providers: CGS does consider dark days when reviewing an exception request. If the dark day affected the processing of the NOE, the provider should note this in their exception request. CGS would not penalize a provider for those days.

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