Medicare Claims Processing Manual (Pub. 100-04), Ch. 27 § 70.3
Handling Emergency Problems and Problems With Recent CWF
70.3 - Handling Emergency Problems and Problems With Recent CWF
Releases
(Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18)
A problem is considered an emergency if a large number of claims are paid incorrectly,
cannot be paid, or the MAC/Host system abnormally ends (abends). When an emergency
occurs, the MAC follows these procedures:
1. The MAC will convey information about the emergency to the Host immediately.
The MAC must be able to submit documentation of the problem.
2. The Host will report the problem to the CWFM immediately via CWFM customer
service. The service is available 24 hours a day, 7 days a week.
3. During business hours, CWFM will respond immediately. After business hours,
CWFM will contact the Host within one hour of report of the problem.