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Eligibility Inquiry

Guidance for CMS offered X12 270/271 Eligibility System (HETS 270/271). The HIPAA Eligibility Transaction System (HETS) is intended to allow the release of eligibility data to Medicare Providers, Suppliers, or their authorized billing agents for the purpose of preparing an accurate Medicare claim, determining Beneficiary liability or determining eligibility for specific services.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: May 24, 2017

CMS offers an X12 270/271 Eligibility System (HETS 270/271).  The HIPAA Eligibility Transaction System (HETS) is intended to allow the release of eligibility data to Medicare Providers, Suppliers, or their authorized billing agents for the purpose of preparing an accurate Medicare claim, determining Beneficiary liability or determining eligibility for specific services.

 

To get more information regarding the HETS Systems please visit the HETS Help website.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.