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 updated HDT User Guide (PDF) will help you get started.
- Medicare HETS - R2023Q400 System Release Will Be Installed 12/9/2023
- Medicare HETS - MCARE Help Desk Customer Services Holiday Schedule
- Medicare HETS 270/271 - Information Bulletin - MSP Diagnosis Codes - September 6, 2023
- Medicare HETS 270/271 - Information Bulletin - HETS Rules of Behavior - June 13, 2023
The HETS 270/271 application is typically available 24 hours a day, 7 days a week. At this time, there are no standing HETS 270/271 maintenance windows. MCARE will notify HETS Trading Partners of any planned downtime. All current and archived downtime notifications are available via the MCARE Notifications link.
The MCARE Help Desk is accessible Monday through Friday, from 7 am to 7 pm ET. The MCARE Help Desk is closed on federal holidays. Be ready to provide examples of any issues in a timely manner for proper support.