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Medicare HETS 270/271 - Information Bulletin - September 9, 2019
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HETS 270/271

Medicare HETS 270/271 Submitters: 

CMS has published updated copies of the current (R2019Q100 – version 10-13) and upcoming (R2019Q300 – version 10-14) HETS 270/271 Companion Guides.  These are updates to clarify interpretation of the HETS 271 response; there are no functional X12 changes included in these revisions.  Section 7.19 (MA Plan Enrollment Business Rules) of each document was updated with a high-visibility clarifying statement about how HETS returns Medicare Advantage (MA) coverage.  Users may need to refresh their browsers to see the new message at the top of Section 7.19. 

CMS returns MA plan eligibility and contact information on the HETS 271 response as a courtesy to the Medicare provider/supplier.  HETS does not have access to the details of MA benefits coverage, therefore it is essential that the Medicare provider/supplier directly contacts the MA plan to obtain all details of the Medicare Beneficiary’s MA eligibility/benefits coverage.

HETS R2019Q100 (current) Companion Guide:  /Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp/Downloads/R2019Q100HETS270271CompanionGuide.pdf (PDF) (version 10-13)

HETS R2019Q300 (upcoming) Companion Guide:  /Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp/Downloads/R2019Q300HETS270271CompanionGuide.pdf (PDF) (version 10-14)

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