Timeliness and Limitations of CWF Responses

30.3 - Timeliness and Limitations of CWF Responses (Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21) Inquirers receive a response within a very short time frame. However, these responses are not truly “real time.” The CWF auxiliary file that retains admission period and period of care information is updated by, and is only as current as, each NOA or claim batch run in CWF. All processed NOAs and claims will update the file, even if claims are ultimately denied. The CWF removes periods from the file only when: • HHAs cancel their own NOA for a period of care that includes no subsequent claims; • HHAs cancel their own claims for periods that were not initially created by an NOA; or • When a A/B MAC (HHH) processing HH claims cancels an NOA or a claim for specific reasons (i.e., fraud). In general, responses will be as current as the previous day. Therefore, even when a response indicates a beneficiary is not currently in an admission period, the possibility exists that an NOA or claim could be in process, and the inquiring agency would still not be the primary HHA for a beneficiary for whom a “clear” inquiry was received. In such cases, the inquiring agency will not learn that it is not the primary HHA immediately. Also possible but even more rare, NOAs or claims from two different HHAs for the same beneficiary for the same date may be in the same batch sent to CWF. In such cases, the claim process will result in one of the two transactions being processed first and thereby deciding which of the two agencies will be primary.