Holding true to the suspicion that a new User Guide is released during a holiday, CMS recently published version 5.6 of the NGHP User Guide.  Updates in this new version include:

• A Windows 10 version of the HIPAA Eligibility Wrapper (HEW) tool that is used for converting Query files is now available for download via the CMS Section 111 website.

What this means to you:
Here at ECS, we take care of the HEW process for our clients. However, if you self-report and are moving to Windows 10, CMS is keeping up with the times by providing a new version of the HEW tool.

• Quarterly claim input files that are submitted manually via the CMS Section 111 website may now only be in .TXT format.

What this means to you:
At ECS, we submit files via SFTP. However, if you self-report, ensure that your claim input files are saved with the .TXT extension.

• File retention has decreased from 180 days to 60 days.

What this means to you:
ECS archives every file we send and receive with CMS, as well as every file we send and receive with our clients. However, if you self-report, ensure that you are maintaining your own archive for historical purposes.

A single PDF containing all five chapters of the User Guide v5.6 can be found here.

As your partner in Section 111 and MSP compliance, ExamWorks is in continuous communication with CMS regarding all updates and process changes.  If you have any questions regarding the latest updates from CMS, or Section 111 in general, please contact your MMSEA Compliance Manager directly, or our Reporting Services Team at MIRService.Support@examworkscompliance.com / 678-222-5454