- Introduction
- Chapter I - Online System Terminology
- Chapter II - Online Menu Functions Overview
- Chapter III - Navigating the Online System
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Chapter IV - Inquiries Submenu (01)
- Accessing the Inquiries Submenu
- Beneficiary/CWF (10)
- DRG (Pricer/Grouper) (11)
- Claim Summary (12)
- Revenue Codes (13)
- HCPCS Codes (14)
- DX/Proc Codes ICD-9 (15)
- Adjustment Reason Codes (16)
- Reason Codes (17)
- ZIP Code File (19)
- OSC Repository Inquiry (1A)
- Claim Count Summary (56)
- Home Health Payment Totals (67)
- ANSI Reason Codes (68)
- Invoice Number/DCN Translator (88)
- DX Proc Codes ICD-10 (1B)
- Community Mental Health Centers Services Payment Totals (1C)
- Check History (FI)
- Provider Practice Address Query (1D)
- New HCPCS Screen (1E)
- Opioid Use Disorder (OUD) Demo 99 (1F)
- Chapter V - Claims and Attachments Submenu (02)
- Chapter VI - Claims Correction Submenu (03)
- Chapter VII - Online Reports View Submenu (04)
-
Resources
- Part A Electronic Medicare Secondary and Tertiary Payer Specifications for ANSI Inbound Claim
- Electronic Medicare Secondary Payer Specifications for Inbound Claims
- FISS UB-04 Data Entry Payer Codes
- Common Claim Status/Locations
- FISS Reason Code Overview
- FISS Reason Code/Claim Driver Overview
- Program Function/Escape Key Crosswalk
- How to Adjust a Claim
- FISS Claim Change/Condition Reason Codes
- How to Cancel a Claim
- How to Correct a Return to Provider Claim
- Online System Menu Quick-Reference
Introduction
Accessing the Common Working File
Beneficiary eligibility records, which are maintained for CMS by the SSA, are stored electronically in the CWF system. You can access CWF records to view beneficiary eligibility information in using the FISS/DDE Provider Online System Beneficiary/CWF (10) option for beneficiary eligibility inquiries.
Note: On 11/1/2019, CMS notified submitters via notification on the MCARE website and message on CWF screens that CMS would begin revoking direct access to CWF eligibility transactions HIQA, HIQH, ELGA and ELGH effective 2/1/2020.
CMS completed removing the direct access to the CWF transactions for many of the large vendors and clearinghouses. For most users, this was transparent because your vendor or clearinghouse automatically routed the eligibility queries to the HETS.
Beginning January 2021, MACs will contact submitters who have direct access to CWF queries and access to HETS, as notice, CMS will discontinue direct access to the CWF transactions upon notification by the MAC. If you do not have access to HETS, the MACs will contact you to discuss an alternative way to access beneficiary eligibility. CMS will not discontinue your access until there is a viable solution and transition.
If you currently use the FISS/DDE, you can continue; CMS is not discontinuing that access. CMS expects to remove all direct access to the CWF transactions by December 2021.
Revised 7/9/2021