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HOW TO GET ACCESS Access Process for Clearinghouses/Providers: In order to obtain access to the HETS 270/271 via the Medicare Data Communication Network (MDCN) a submitter needs to complete the appropriate forms. You can access these forms at the bottom of this page in the Related Links Inside CMS section. The first form to be completed is the TRADING PARTNER AGREEMENT FOR SUBMISSION OF 270s TO MEDICARE ON A REAL-TIME BASIS. This agreement outlines security and privacy procedures for the submitters requesting access to the Medicare Beneficiary database. In addition, all submitters must agree to CMS Eligibility Rules of Behavior before submitting eligibility requests. If submitters do not comply with the CMS Eligibility Rules of Behavior, this could result in revoked or denied access and other penalties. The submitter must electronically provide the information requested on the form and click on the appropriate assurances. If the submitter does not consent to the terms of the agreement by appropriately completing the form, the access process will be terminated. If the submitter checks the appropriate boxes on the agreement and supplies the information requested, a copy of the completed electronic form will be submitted to the Medicare Eligibility Integration Contractor (MEIC) for security authentication. The submitter will then be directed to complete the Medicare Data Communication Network (MDCN) connectivity form and submit it electronically in order to be connected to the HETS 270/271 eligibility database. Effective September 2006, CMS restricted application and access to the Medicare HETS 270/271 system to only direct Medicare providers or suppliers. As a result, no applications have been accepted from clearinghouse or clearinghouse-type organizations since September 2006. CMS also recently enacted a moratorium on new Third Party Vendor submitters. Establish Submitter ID CMS staff will ensure that all of the necessary information is provided on the form, as well as ensuring that connectivity to the 270/271 application has been established. The MEIC will be responsible for contacting the Trading Partner to authenticate the identity of the accessing entity. Once authentication has been completed, the MEIC will provide the Trading Partner with a submitter ID that is required on all 270/271 transactions. Testing will be coordinated by the MCARE Help Desk, and after successful testing, 270 production inquiries may be sent real-time. Please note that in order to access the Medicare Data Communication Network (MDCN), an entity must, on its own, obtain the necessary telecommunication software from the AT&T Reseller. The current AT&T Resellers contact numbers are listed below: IVANS: (800) 548-2675 McKesson: (800) 782-7426, select option 5, then select option 8 CONNECTION OVERVIEW Trading Partners will access the CMS Data Center, via the AT&T communication Extranet, over the Medicare Data Communication Network (MDCN), to send their eligibility requests. This Extranet is a secure, closed, private network currently used to transmit data between Medicare Fee-for-Service (FFS) contractors and CMS. For a 270 real-time inquiry, the software at the CMS data center will translate the incoming 270, perform validations, request Beneficiary eligibility information from the CMS eligibility database, and create either a 271, 997, TA1 or proprietary response. CMS will continue to hold Clearinghouses responsible for the privacy and security of eligibility transactions sent directly to them from Providers, and to require them to be able to associate each inquiry with a Provider. Provider authentication must be established outside of the transaction. Trading Partners must not send User IDs and passwords within the 270 eligibility transaction. HOW TO OBTAIN A CONNECTION TO THIS SERVICE To sign up as an Extranet eligibility submitter, your organization must complete the following forms to obtain a connection to the Medicare Data Communication Network (MDCN) via an AT&T Global Network Service (AGNS) connection: Trading Partner Agreement for Submission of 270s to Medicare on a Real-Time Basis, Eligibility Rules of Behavior, and MDCN Connectivity Form. You can obtain an AGNS connection from one of the approved AT&T Resellers: IVANS or McKesson. Contact information for each company is available on the "How to Get Connected – HETS 270/271" page. Please contact the AT&T Resellers for pricing and additional information. Once you have reached the MDCN via an AGNS connection, you can then access the Medicare HETS 270/271 Eligibility System to inquire for eligibility. WHAT TO DO IF YOUR CONNECTION CLOSES The Extranet Eligibility System will automatically terminate a session (without notice) if the socket has been idle for more than 5 seconds. If this occurs, open a new socket and resume sending transactions.
Page Last Modified: 11/12/2008 11:35:48 AM
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