HETS EDI Enrollment Form

HIPAA Eligibility Transaction System (HETS) allows users to exchange HIPAA compliant ANSI ASC X12 270/271 transactions for the purpose of checking Medicare eligibility. 

The HETS EDI Enrollment Form allows providers to attest their relationship with a 3rd party entity to exchange the ANSI X12 270/271 Beneficiary Eligibility transaction on their behalf.

Complete a Form Here

If you're ready to fill out a HETS EDI Enrollment Form, click the button below.

• Start the HETS EDI Enrollment Form

For questions regarding how to complete and submit the HETS EDI Enrollment Form, please contact the EDI Help Desk at 888-379-9132, or you may submit your questions via the EDI E-mail Inquiry Form.

For questions regarding HETS, including enrolling to exchange the 270/271 Beneficiary Eligibility transaction, please contact HETS at MCARE@cms.hhs.gov or at 1-866-324-7315. For additional information regarding HETS, visit https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp.