HETS 3rd Party Attestation 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 3rd Party Attestation 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.

Internal link to the HETS 3rd Party Attestation Form

Instruction Guide Internal PDF document (354 KB)

FAQ Internal PDF document (351 KB)

For questions regarding how to complete and submit the HETS 3rd Party Attestation Form, please contact the CEDI Help Desk at 866-311-9184, or you may submit your questions via e-mail at ngs.cedihelpdesk@anthem.com.

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 External Link .