HETS updates

Keeping your eligibility transactions efficient and compliant

CMS has announced planned improvements to the HIPAA Eligibility Transaction System (HETS), including changes to transmission methods and functional tweaks for 270/271 transactions. The improvements, set to be released in Q3 this year, will “introduce a more robust technical infrastructure for the HETS 270/271 application,” according to CMS.

As you may know, HETS gives users real-time eligibility and benefits information, and was created to serve as a HIPAA-compliant replacement for Medicare eligibility verification via the Common Working File (CWF). CMS has long stated that it will be eliminating the ELGA, ELGH, HIQA, HIQH, and HUQA Part A eligibility queries from the CWF and, while a date for this change has not been set, it is vital to prepare now.

The good news for Strategic Partners with applications using the HETS system is that ABILITY is already taking the required steps to ensure your uninterrupted access during the CMS upgrade. For most customers, this includes managing the routing and functional changes related to your 270 EDI requests. In the near future, ABILITY will be communicating with your organization to deliver specific information about any additional steps you may need to take.

As with any regulatory or industry change, ABILITY is working closely with CMS to ensure that changes like this one have a minimal impact on your business. As the phased migration to the new system begins, look for further guidance from ABILITY about how to keep your eligibility transactions running as smoothly as possible.