Corporate

September 25, 2019

October 2019 Release "Dark Days” for the Common Working File (CWF) Hosts

To accommodate the anticipated duration of the October 2019 release, and to ensure the completion of weekly/monthly/quarterly processing, the Common Working File (CWF) will not process claims beginning Friday, October 4, 2019 through Sunday, October 6, 2019. During this time, claims will not be sent to CWF and access to ELGA and ELGH will not be available. The next cycle to CWF will occur during the night, Tuesday, October 8, 2019.

In addition, providers should be aware of the following:

  • Out of Service Area (OSA) responses will be dropped from September 30, 2019, through October 4, 2019. 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 during the nightly system cycle on October 8, 2019; therefore, additional time may be required for claims to process and pay.
  • During the “dark days”, October 4 - 6, 2019, 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. For more information about myCGS, refer to the myCGS User Manual.

We anticipate that claims will still be processed within the allowed timeframe. As a reminder, the Medicare Claims Processing Manual (Pub. 100-04, Ch. 1External PDF, § 80.2.1.1) 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 Notices of Election (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: Beneficiary eligibility can still be verified via myCGS and the IVR, and NOEs can still be submitted to CGS during this period. Therefore, if hospice agencies feel that a late submission of an NOE was caused by the dark day, appropriate documentation must be submitted. NOTE: myCGS and the IVR will be available but will not update during the Dark Day period.

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