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How to Get Connected - HETS 270/271

Access Process for Clearinghouses/Providers:

In order to obtain access to the HETS 270/271 application a submitter needs to complete a Trading Partner Agreement (TPA). You can access this form from the Downloads section at the bottom of this page.

The HETS 270/271 TPA outlines security and privacy procedures for the submitters requesting access to the Medicare Beneficiary database. In addition, all submitters must agree to CMS Eligibility Rules of Behavior before submitting eligibility requests. The CMS Eligibility Rules of Behavior can be found in the Downloads section of the “Security – HETS 270/271” page.  Noncompliance with the CMS Eligibility Rules of Behavior could result in revoked or denied access and other penalties.

The applicant must complete, print, sign, scan and return the entire TPA agreement to CMS via email to the mcare@cms.hhs.gov mailbox.  All submitters must provide the information requested on the form and click on the appropriate assurances. If the submitter does not consent to the terms of the agreement by appropriately completing the form, the access process will be terminated.

Applicants must complete, print, sign, scan and return the entire TPA agreement to CMS via email to the mcare@cms.hhs.gov mailbox.  All pages must be included in the application, even if there is no specific data entered on that page. CMS requests that submitters complete the application electronically before printing, signing and scanning a copy – CMS requests that applicants please do not write in their responses by hand.  CMS also requests that applicants scan the entire document as a single file (instead of separate pages).  CMS requires that submitters encrypt the TPA file before sending it to the MCARE Help Desk.  CMS requests that all applicants email the completed application via email to mcare@cms.hhs.gov using the email subject line “HETS 270/271 TPA Request.”  The completed, signed, scanned and encrypted file must be submitted to the Medicare Customer Assistance Regarding Eligibility (MCARE) Help Desk for security authentication and connection to the HETS270/271 application's eligibility database.

Establish Submitter ID

CMS staff will ensure that all of the necessary information has been provided on the TPA, as well as ensuring that connectivity to the HETS 270/271 application has been established. The MCARE Help Desk will be responsible for contacting the submitter to authenticate their identity. Once authentication has been completed, the MCARE Help Desk will provide the proposed submitter with a submitter ID that is required on all HETS 270/271 application transactions. Testing will be coordinated by the MCARE Help Desk, and after successful testing, 270 production inquiries may be sent real-time.

Connection Overview

Submitters may access the CMS Data Center using the CMS Extranet or by establishing internet connectivity using Simple Object Access Protocol (SOAP) + Web Services Description Language (WSDL) envelope standards hereafter referred to simply as SOAP or Hypertext Transfer Protocol (HTTP)/Multipurpose Internet Mail Extensions (MIME) Multi-part envelope standards hereafter referred to simply as MIME.

The CMS Extranet is a secure, closed, private network currently used to transmit data between CMS and CMS Business Partners.  Connections using SOAP or MIME are secured by the use and verification of Digital Certificates.

For a 270 real-time inquiry, the software at the CMS data center will translate the incoming 270, perform validations, request Beneficiary eligibility information from the CMS eligibility database, and create either a 271, 999, TA1 or proprietary response.

CMS will continue to hold Clearinghouses responsible for the privacy and security of eligibility transactions sent directly to them from Providers, and will require them to be able to associate each inquiry with a Provider. Provider authentication must be established outside of the transaction. Submitters must not send User IDs and passwords within the 270 eligibility transaction. For additional information regarding connectivity best practices, please refer to the “Best Practices for Managing HETS Connections” document found in the Downloads section below.

How to Obtain a Connection to this Service

To sign up, HETS 270/271 submitters must complete a TPA and obtain a connection to the HETS 270/271 using the CMS Extranet via an IP connection or by establishing a connection using SOAP or MIME communication protocols.

To connect to the 270/271 application via the CMS Extranet, you can obtain an IP connection from one of the approved Network Service Vendors. The current Network Service Vendors' contact numbers and email addresses are listed below:

• ABILITY Network/IVANS: (888) 895-2649, sales@abilitynetwork.com
• AHDS: (877) 214-0990, info@ahds.com
• ECC Technologies RAPID Network: (855) 643-2252, rapidinfo@ecctechnologies.com
• eSolutions: (866) 633-4726, info@esolutionsinc.com
• McKesson: (888) 663-6250, quote@carebridge.net
• MedTranDirect: (855) 855-6637, sales@medtrandirect.com

Please contact the Network Service Vendors for pricing and additional information.  Note:  The HETS 270/271 application will automatically terminate a CMS Extranet based session without notice if the socket has been idle for more than 5 seconds. If this occurs, open a new socket to resume sending transactions.

A  SOAP or MIME connection may be established by contacting the MCARE Help Desk and following the instructions found in the document “HETS SOAP MIME Connectivity” which can be found in the Downloads Section below.

Once a connection to the CMS Extranet has been established via an IP connection or using SOAP or MIME communication protocols, the Medicare HETS 270/271 application may be accessed for eligibility inquiries.

Best Practices

CMS has compiled a list of HETS submitter "Dos" and "Don'ts" to provide additional guidance regarding HETS 270/271 communications best practices. A copy of the “Best Practices for Managing HETS Connections” document is available in the Downloads sections below.

CMS requires that all HETS 270/271 submitters read this document and then review their HETS communication protocol practices to ensure that their organization is following these best practices. CMS will contact submitters whose behavior is not consistent with these practices to determine the submitter's action plan to improve.