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HIPAA Eligibility Transaction System (HETS)

The HIPAA (Health Insurance Portability and Accountability Act) Eligibility Transaction System (HETS) allows you to check Medicare beneficiary eligibility data in real-time. Use HETS to prepare accurate Medicare claims, determine beneficiary liability, or check eligibility for specific services.

HETS allows users to submit HIPAA compliant 270 eligibility request files over a secure connection and receive 271 response files. Submitters must develop or acquire a tool to construct and send 270 eligibility request files and receive and deconstruct 271 eligibility response files in a real-time environment. HETS 270/271 application supports real-time transactions only.  The HETS 270/271 application does not accept batch transactions.

Our HDT User Guide [PDF, 2MB]  will help you get started.

Recent Announcements

Important Announcements:

System Maintenance

Regularly scheduled maintenance occurs every Monday from 12 to 5 am ET. Please plan accordingly; the system is unavailable and transactions will not process during this period.

Contact Us

The MCARE Help Desk is accessible Monday through Friday, from 7 am to 7 pm ET. Be ready to provide examples of any issues in a timely manner for proper support.