February 1, 2010, Home Health & Hospice Medicare A ... - CGS

Example 2: A future date of 05/01/2010 is entered in the ‘APP DATE’ field.ELGH CWF PART A ELIGIBILITY SYSTEM ELGASAT101/08/2010 14:23:00 INQUIRY BY HOME HEALTH AGENCYENTER THE FOLLOWING FIELDS:HIC NUMBER : 123456789ASURNAME : SmithINITIAL : JDATE OF BIRTH : 01011920 (MMDDCCYY)SEX CODE : MREQUESTOR ID : 0011INTER NO : 00011NPI INDICATOR :N-NPI or BlankPROVIDER NO : XXXXXXHOST-ID : GL, GW, KS, MA, PA, NE, SE, SO, SWAPP DATE : 05012010 (MMDDCCYY)REASON CODE : 1RESPONSE CODE : PIn this example, only the two most recent benefit periods display because, the ‘TERM DATE’ dates for eachperiod, 11/24/2009 and 01/23/2010, are within six months prior to the date entered in the ‘APP DATE’field.ELGH CWF PART A ELIGIBILITY SYSTEM ELGHCRO01/08/2010 14:44:47 HOSPICE INFORMATION PAGE 09 OF 09HOS-REC CN 123456789A NM SMITH IT J DB 01011920 SX MHOSPICE PERIOD 1 PERIOD 2 PERIOD PERIOD PERIODSTART DATE 09/26/2009 11/25/2009TERM DATE 11/24/2009 01/23/2010PROVIDER NO XXXXXX XXXXXXINTER NO XXXXX XXXXXREVOC INDNote: In Example 2, if the future date of 07/25/2010 or after would be entered in the ‘APP DATE’ field, nohospice benefit period information would display because the ‘TERM DATE’ is not within 6 months priorto the date entered.If you are having difficulty determining whether the beneficiary is in a 60- or 90-day benefit period, wesuggest that you review the ELGA/ELGH eligibility screens again, after your Notice of Election (NOE) hasprocessed (status/location P B9997). Once the NOE is processed, the ELGA/ELGH screens will update toidentify the Start and Term dates of the hospice benefit period to which your admission applies.In addition, the CWF system release also changed how hospice benefit period information is displayed onthe ELGA/ELGH eligibility screens. Previously, the most recent benefit period information was displayedon the left side of the screen. With these changes, the most recent benefit information now displays on theright.The hospice benefit period information is also provided on Cahaba’s Interactive Voice Response (IVR).If you have questions about this information, please call a customer service representative in our ProviderContact Center at 1-866-539-5592.Home Health & Hospice February 1, 2010 45Medicare A Newsline Vol. 17, No. 5