CMS Changes to Common Working File ELGB Query – 2014 Update in Announcements Section

Posted on March 19, 2013 by david.fox
On April 1, 2013,CMS (Centers for Medicare and Medicaid Services) will discontinue the ELGB (eligibility) query which DME and Part B providers use for eligibility from the Common Working File (CWF) through the Fiscal Intermediary Standard System (FISS) and Direct Data Entry (DDE) systems. Only in the Multi-Carrier System (MCS) and ViPS Medicare System (VMS) will be discontinued. These systems are more commonly known as PPTN and VPIQ.This change will NOT impact DDE claims submission or correction.These changes will impact different Passport products in   different ways:

  • Passport products that use HETS*  will experience NO CHANGE. These products include: OneSource,  BatchSource, Passport eCare NEXT and EDI.
  • Passport products that use a HIQA and HIQH embellishment will not be impacted by this change at this time.
  • Nebo products that rely on the ELGB query through the CWF will lose access to eligibility queries as of April 1, 2013.  These products include: Nebo eCare Claims Management System and MediTrak  (VPN connectivity to CMS’ CWF).  The alternative is to use eCare Online that already utilizes the HETS/CMS eligibility database.  If  you do not have access to eCare Online and would like to enroll, please  go to http://www.passporthealth.com/Enrollment/eCare-Enroll.htm and complete the online application.

*HETS is Medicare’s Health Care Eligibility Benefit Inquiry and   Response electronic transaction. CMS began offering HETS in 2005 and it will   be the only 270/271 eligibility system going forward.

CMS has announced it will be discontinuing other eligibility   queries but specific dates have not been announced. These include:

  • HIQA
  • HIQH
  • ELGA
  • ELGH
  • HUQA

We will update this announcement once we receive a firm   date these queries will be discontinued.
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