The HIPAA Eligibility Transaction System, or HETS, was introduced by the Centers for Medicare and Medicaid Services in 2005 to support real-time Medicare eligibility inquiries using the HIPAA ANSI 270 (eligibility request) and ANSI 271 (eligibility response) transactions. Recent announcements by CMS have centered attention on this process since it will soon be the only method of obtaining this information for Medicare patients.
CMS announced through a revised MLN Matters document on April 23 that the access of eligibility data through the Common Working File (CWF) will be discontinued in April 2014. For over 20 years, providers have used terminals or terminal emulation software to connect to the CWF and view eligibility and claims data. Many software applications have been developed that access this system to obtain this information and redistribute it through reports. These processes will need to be modified or abandoned by providers and software developers before they cease to exist.
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