Eli's Hospice Insider

Published on Wed Dec 18, 2013 PDF

CMS still plans to get rid of the ELGA/ELGH system for looking up patient eligibility this April, but getting the replacement HETS system up and running hasn’t been entirely smooth.

For example: CMS is “postponing the implementation of the quarterly release of their HETS 270/271 system due to issues they encountered,” reports HHH Medicare Administrative Contractor Palmetto GBA. CMS is adding information to the system with this quarterly release, including hospice revocation dates. Online Provider Services (OPS) users “will be able to see the new fields in OPS, but the data will not display until the corrected HETS 270/271 quarterly release is available,” Palmetto says. At press time, CMS estimates that date as Dec. 16.

Reminder: CMS will terminate the ELGA/ ELGH lookup system April 7, MAC CGS says in a new article posted to its website.

Tip: To reduce the chance of denied or returned claims, you should always check these claim elements upon admission and before each claim, advises HHH MAC CGS: spelling of patient’s first and last name, Medicare number, Medicare Advantage plan, and Part A/Part B status. “Hospice patients must be entitled to Medicare Part A,” CGS notes.

CGS’s article on the topic is at http://cgsmedicare.com/hhh/pubs/news/2013/1113/cope23955.html. A CMS MLN Matters article about the ELGA/ELGH termination is at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8248.pdf.