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March 29, 2017

April 2017 Release "Dark" Days for the Common Working File (CWF) Hosts

To accommodate the April 2017 release, there will be a period, referred to as "dark days," when the CWF Hosts will not process claims. This period begins Friday, March 31, 2017 through Sunday, April 2, 2017. 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, Monday April 3, 2017.

In addition, providers should be aware of the following:

  • Out of Service Area (OSA) responses will be dropped from March 27, 2017, through March 31, 2017. 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 April 3, 2017; therefore, additional time may be required for claims to process and pay.
  • During the "dark days", March 31 through April 2, 2017, 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. 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: Beneficiary eligibility can still be verified via myCGS and the IVR, and NOEs can still be submitted to CGS during this period. Therefore, if hospices can provide documentation showing the NOE was submitted on the day before a dark day period, but the NOE did not receive a receipt date until the day following the dark day, CGS will grant an exception for the timely filing requirement.

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