HIPAA Eligibility Transaction System (HETS) Help (270/271)

HETS 270/271 Information

Acceptable Query Date Ranges

CMS will verify that the requested date(s) on the 270 request are within the HETS 270/271 application's allowable date span.  The HETS 270/271 application will accept requests for specific periods up to 27 months in the past and up to four months in the future based on the date the transaction was received.  To avoid misunderstandings and variations in responses, requests outside of the range will be rejected with the 2100C level AAA error with AAA03 = '62': Date of Service Not Within Allowable Inquiry Period.

 

 

Table of Acceptable Query Date Ranges
If This Month Is:Historical Requests Are Valid Through:Future Requests Are Valid Through:
JanuaryOctober, 3 years agoMay of this year
FebruaryNovember, 3 years agoJune of this year
MarchDecember, 3 years agoJuly of this year
AprilJanuary, 2 years agoAugust of this year
MayFebruary, 2 years agoSeptember of this year
JuneMarch, 2 years agoOctober of this year
JulyApril, 2 years agoNovember of this year
AugustMay, 2 years agoDecember of this year
SeptemberJune, 2 years agoJanuary of next year
OctoberJuly, 2 years agoFebruary of next year
NovemberAugust, 2 years agoMarch of next year
DecemberSeptember, 2 years agoApril of next year

Again, this is just one of many steps CMS is taking to improve the Medicare Eligibility transaction. You can share your comments or concerns with CMS by contacting the Medicare Customer Assistance Regarding Eligibility (MCARE) Help Desk.

MCARE Help Desk: 1-866-324-7315

TCP/IP Communication Transport Protocol Wrapper

Each submitted transmission shall contain one 270 transaction with only one ISA and IEA segment, along with a transmission wrapper around the 270 transaction. The transmission wrapper Header/Trailer has no Segment ID associated with it and requires the length of the transaction message. There will be no handshake after the connection is accepted with the first submitted transmission.

Outbound response transactions will have the same format transmission wrapper. The 271 response to the submitter will be returned in the same session in which the 270 was submitted.

Standard format of the TCP/IP Communication Transport Protocol Wrapper:

SOHLLLLLLLLLLSTX<HIPAA 270 Transaction>ETX

SOH = Required (1 positions), must be ASCII - 01

LLLLLLLLLL = Required (10 positions), Right justified with zero padded

Note: Length of the HIPAA 270 transaction not including Transmission wrapper data.

STX = Required ( 1 positions), must be ASCII - 02

<HIPAA 270 Transaction> = Required (HIPAA 270 – ISA-IEA)

ETX = Required (1 positions), Must be ASCII - 03

Note: For more details about SOH, STX and ETX see the Health Care Eligibility Benefit Inquiry and Response 270/271 ASC X12 Extended Control Set in the ASC X12 Standards for Transactions 270/271 005010X279A1 Implementation Guide.

Refer to the Downloads section below for a 270 Request example and a 271 Response example (with field explanation.)

Downloads

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