evekhm/cms_iom_500 huggingface dataset:
(Medicare Claims Processing Manual Crosswalk)
60.1 12000.1 Initial Determination29 60.2  12000.2       PM-AB-00-122 Steps in the Appeals Process: Overview 29 60.3 12001 FI and Carrier Correspondence With Beneficiaries Or Other Parties Regarding Appeals 29 60.4  12002        Parties To An Appeal 29 60.5  12004        Appointment Of Representative 29 60.5.1  12004.1 600 287.4B 257B 383B  628  Appointment of Representative - Introduction 29 60.5.2  12004.2        Who May Be A Representative 29 60.5.3  12004.3        How to Make and Revoke an Appointment 29 60.5.4  12004.4        When to Submit the Appointment 29 60.5.5  12004.5        Where to Submit the Appointment 29 60.5.6 12004.6 PM-B-02-074 Right s and Responsibilities of a Representative 29 60.5.7  12004.7        Validity of an Appointment Over Time 29 60.5.8 12004.8 Timeliness of an Appeal Request and Completeness of Appointment 29 60.5.9  12004.9        Powers of Attorney 29 60.5.10  12004.1        Incapacitation or Death of Beneficiary 29 60.5.11 12004.11 Disclosure of Individually Identifiable Beneficiary Information to Representative Chap. Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09HO Pub. 10HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 OTHER Description 29 60.6  12006        Amount In Controversy 29 60.6.1  12006.1        Amount in Controversy Defined 29 60.6.2  12006.2        Amount in Controversy General Requirements 29 60.6.3  12006.3        Calculating the Amount in Controversy 29
(Medicare Claims Processing Manual Crosswalk)
60.6.4 12006.4 Additional Considerations for Calculation of the Amount in Controversy 29 60.6.5 12006.5 Aggregation of Claims to Meet the Amount in Controversy 29 60.7 12008 Extension Of Time Limit For Filing A Request For Review Or Fair Hearing 29 60.7.1 12008.1 Good Cause29 60.7.2  12008.2        General Procedure to Establish Good Cause 29 60.7.3 12008.3 Conditions that May Establish Good Cause for Late Filing by Beneficiaries 29 60.7.4 12008.4 Examples of Situations Where Good Cause for Late Filing Exists for Beneficiaries 29 60.7.5 12008.5 Conditions that May Establish Good Cause for Late Filing by Physicians or Other Suppliers 29 60.7.6 12008.6 Examples of Situations Where Good Cause for Late Filing Exists for Physician or Other Suppliers 29 60.7.7 12008.7 Good Cause Not Found for Beneficiary, or for Provider, Physician or Other Supplier 29 60.8  12009        Fraud And Abuse 29 60.8.1  12009.1        Fraud and Abuse - Authority Chap. Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09HO Pub. 10HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 OTHER Description 29
(Medicare Claims Processing Manual Crosswalk)
60.8.2 12009.2 Inclusion and Consideration of Evidence of Fraud and/or Abuse 29 60.8.3 12009.3 QIO-7560 Claims Where There Is Evidence That Items or Services Were Not Furnished, or Were Not Furnished as Billed 29 60.8.4 12009.4  Responsibilities of Reviewers and Hearing Officers 29 60.8.5  12009.5        Requests to Suspend the Appeals Process 29 60.8.6 12009.6 Continuing Appeals of Providers, Physicians or Other Suppliers Who are Under Fraud or Abuse Investigations 29 60.8.7 12009.7 Appeals of Claims Involving Excluded Providers, Physicians or Other Suppliers 29 60.9  12010        Guidelines For Writing Appeals Correspondence 29 60.9.1 12010.1 General Guidelines29 60.9.2 12010.2 Letter Format29 60.9.3  12010.3        Required Elements in Appeals Correspondence 29 60.10  12011        Disclosure Of Information 29 60.10.1 12011.1 General Information29 60.10.2  12011.2        Fraud and Abuse Investigations 29 60.10.3  12011.3        Medical Consultants Used 29 60.10.4 12011.4 Multiple Beneficiaries29 60.11  12012        Review - The First Level Of Appeal  29 60.11.1  12012.1        Filing a Request for Review 29 60.11.2 12012.2 Time Li mit for Filing a Request for Review Chap. Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09HO Pub. 10HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 OTHER Description 29
(Medicare Claims Processing Manual Crosswalk)
60.11.3 12012.3 Recording of Inquiries and Other Actions on the Carrier Appeal Report (FI - Form CMS-2591, Carrier - Form CMS-2590) 29 60.11.4 12012.4 The Review29 60.11.5  12012.5        The Review Determination 29 60.11.6  12012.6        Review Determination Letter 29 60.11.7  12012.7        Effect of the Review Determination 29 60.12  12013        Telephone Review Procedures 29 60.12.1 3795 12013.1 RO-9005.3 Informing the Beneficiary and Provider Communities about The Telephone Review Process 29 60.12.2 3796 12013.2        Issues for Telephone Reviews 29 60.12.3 3796.1 12013.3        Issues During the Telephone Review 29 60.12.4 3797 12013.4        Time Limit for Requesting a Telephone Review 29 60.12.5 12013.5 Review Requests Made on Behalf of the Party on the Telephone 29 60.12.6 3790 12013.6       QIO-7400 Conducting the Telephone Review 29 60.12.7 3790.1 12013.7        Documenting the Call 29 60.12.8 3790.2 12013.8        Timely Processing Requirements 29 60.12.9 3799 12013.9 620 288  384  630  Review Determination Letters 29 60.12.10 12013.10 Education29 60.12.11  12013.11        Monitoring Telephone Reviews 29 60.13  12014        Fair Hearing - The Second Level Of Appeal 29 60.13.1  12014.1        Filing a Request for Fair hearing Chap.                                                                                                          Qualif ications and General Responsibilities Sect Int. Pub.13-3  Carrier Pub.14-3  OPT Pub. 09 HO Pub. 10 HH Pub. 11
(Medicare Claims Processing Manual Crosswalk)
Qualif ications and General Responsibilities Sect Int. Pub.13-3  Carrier Pub.14-3  OPT Pub. 09 HO Pub. 10 HH Pub. 11  SNF Pub. 12 Disqualification of HO HSP Pub. 21 RHC Pub. 27 OTHER Description29 60.13.2 12014.2 Time Limit for Filing A Request for Fair Hearing 29 60.13.3 12014.3 Request for HO hearing Filed Prior to a Review Determination 29 60.13.4 12014.4 Exceptions to Filing Requirements 29 60.14  12016        Request For HO Hearing 29 60.14.1  12016.1        Timely Processing Requirements 29 60.14.2 12016.2 Cont ractor Responsibilities  General 29 60.14.3  12016.3        Requests for Transfer of In-Person Hearings 29 60.14.4  12016.4        Acknowledgment of Request for HO hearing 29 60.14.5  12016.5        Case File Development 29 60.14.6  12016.6        Case File Preparation 29 60.15  12017        Types Of Fair Hearings 29 60.15.1 12017.1 In-Person Hearing29 60.15.2 12017.2 Telephone Hearing29 60.15.3  12017.3        On-the-Record (OTR) Hearing and Decision 29 60.15.4 12017.4 Preliminary On-The-Record (POTR) Hearing and Decision 29 60.16 12018 Hearing Officer (HO) Authority And Responsibilities 29 60.16.1  12018.1        Hearing Officer (HO) Authority 29 60.16.2 12018.229 60.16.3  12018.3 Chap.                                                                                    Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09 HO Pub. 10 HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 29 OTHER60.17 Description
(Medicare Claims Processing Manual Crosswalk)
Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09 HO Pub. 10 HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 29 OTHER60.17 Description 12019        Fair Hearing Procedures 29 60.17.1  12019.1        Preparation for the Fair Hearing 29 60.17.2 12019.2 Scheduling the Date, Time and Place of Hearing 29 60.17.3 12019.3 Adjournment and/or Postponement of Telephone or In-person Hearing 29 60.17.4  12019.4        Pre-Hearing Review of the Evidence 29 60.17.5 12019.5 Forwarding Copy of Case File Prior to Telephone Hearing 29 60.17.6  12019.6        In-Person and Telephone HO hearing Procedures 29 60.17.7  12019.7        The Fair Decision Timeliness 29 60.18  12020        Effectuation Of Fair Hearing Decisions 29 60.18.1 12020.1 General Rule29 60.18.2 12020.2 Delaying Effectuation29 60.18.3 12020.3 Elemen ts of Written Request for Reopening 29 60.18.4  12020.4        Notice to Parties of Reopening Request 29 60.18.5  12020.5        HO Reply to Reopening Request 29 60.18.6  12020.6        Notice to Parties of HO Determination 29 60.19 12026 Requests For Part B Administrative Law Judge (ALJ) Hearing 29 60.19.1  12026.1        Right to Part B ALJ Hearing 29 60.19.2  12026.2        Forwarding Requests to SSA/OHA 29 60.19.3  12026.3        Case File Preparation Chap.
(Medicare Claims Processing Manual Crosswalk)
Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09 HO Pub. 10 HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 OTHER Description29 60.19.4  12026.4        Acknowledgment of Request for Part B ALJ Hearing 29 60.19.5 12026.5 Model Format for Acknowledgment of ALJ Hearing Request 29 60.20 12028 Effectuation Of Part B Administrative Law Judge (ALJ) Decisions/Dismissals 29 60.20.1  12028.1        Review and Effectuation of ALJ Decisions - General 29 60.20.2  12028.2        Effectuation Time Limits 29 60.20.3  12028.3        ALJ Data Extraction Form 29 60.20.4  12028.4        Misrouted ALJ Case Files 29 60.20.5  12028.5        Duplicate ALJ Decisions 29 60.21 12029 Recommending Agency Referral Of Part B ALJ Decisions Or Dismissals To The CMS RO  29 60.21.1 12029.1 Time Limits for Forwarding Agency Referral Memorandum to CMS RO 29 60.21.2  12029.2        Guidelines for Reviewing ALJ Decisions/Dismissals 29 60.21.3  12029.3        Draft Agency Referral Memorandum Content 29 60.21.4  12029.4        Draft Memorandum Format 29 60.21.5 12029.5 Submission of Draft Agency Referral Memorandum to CMS RO 29 60.22  12032        Effectuation Of DAB Orders And Decisions 29 60.22.1 12032.1 Background29 60.22.2  12032.2       PM-AB-01-62 Requests for Case Files 29 60.22.3 12032.3 Cont ractor Effectuation Responsibilities Chap.
(Medicare Claims Processing Manual Crosswalk)
Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09 HO Pub. 10 HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 OTHER Description29 60.22.4          Payment of Interest on DAB Decisions 29 60.23  12033        Request For U.S. District Court Review By A Party 29 60.24  12034        Effectuation Of U.S. District Court Decisions 29 60.24.1          Payment of Interest on U.S. District Court Decisions 29 60.25 12040 Review And Analysis o Initial Determinations And Appeal  29 60.27 12100 Reopening and Revision of Claims Determinations and Decisions 29 60.27.1  12100.1        Development of Appeals 29 60.27.2  12100.2        How Issues May Arise 29 60.27..3 12100.3 Summary of Conditions Under Which a Determination or Decision May Be Reopened 29 60.27.4 12100.4 Determining Date of Initial or Reviewed Determination, or HO's Decision 29 60.27.5 12100.5 Who May Reopen an Initial or Reviewed Determination or HO's Decision 29 60.27.6 12100.6 Actions to Permit Reopening Within the l-Year or 4-Year Period 29 60.27.7  12100.7        Good Cause for Reopening 29 60.27.8 12100.8 Definitions29 60.27.9 12100.9 Unrestricted Reopening29 60.27.10  12100.10        Reopening an Initial Decision 29 60.27.11  12100.11        Reopening a Review Determination Chap.
(Medicare Claims Processing Manual Crosswalk)
Sect Int. Pub.13-3 Carrier Pub.14-3 OPT Pub. 09 HO Pub. 10 HH Pub. 11 SNF Pub. 12 HSP Pub. 21 RHC Pub. 27 OTHER Description29 60.27.12  12100.12        Reopening a Fair Hearing Decision 29 60.27.13  12100.13        Notice of Results of Reopening 29 60.27.14 12100.14 Exception to Sending Notice of Revision to Parties--Cases Involving Limitation on Recovery from Beneficiary 29 60.27.15  12100.15        Refusal to Reopen Is Not an "Initial Determination" 29 60.27.16  12100.16        Revised Determination or Decision 29 60.28  12999        List of Exhibits 29 70 12900 Glossary
(Medicare Claims Processing Manual Crosswalk)
Medicare Claims Processing Manual Chapter 30 - Financial Liability Protections  New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs                        Other Description30 10 Financial Liability Protections (FLP) Provisions of Title XVIII  30 20 A3-3431 B3-7300.1 Limitation On Liability (LOL) Under 1879 Where Medicare Claims Are Disallowed 30 20.1 - 20.1.3  B3-7300.2, B3-7300.3 CMS Rulings:  Coverage Denials to Which the Limitation on Liability Applies     95-1,    96-2,    96-3,    97-1 30 20.2 - 20.2.2   PM AB-02-168     Part I  CMS Ruling 95-1,  Denials for Which the Limitation On Liability Provision Does Not Apply 30 30 A3-3432 B3-7300.4 Determining Liability for Disallowed Claims Under 1879 30 30.1 - 30.1.2 A3-3432.1  PM AB-02-168  Determining Beneficiarys Liability  30 30.2 - 30.2.3 A3-3432.2   CMS Ruling 95-1 Determining Provider, Practitioner, or Supplier Liability  New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 30                      40 A3-3432.1 PM AB-02-168  CMS Ruling 95-1 Determining Knowledge for FLP Purposes  30 40.1 - 40.1.4 A3-3439, A3-3440   CMS Ruling 95-1 Determining Whether Provider, Practitioner, or Supplier Had Knowledge of Noncoverage of Services  30 40.2 - 40.2.4 A3-3439.1 B3-7300.5  CMS Ruling 95-1 Determining Whether Beneficiary Had Knowledge of Noncoverage of Services
(Medicare Claims Processing Manual Crosswalk)
30 40.3 - 40.3.8   PM AB-02-168  Advance Beneficiary Notice Standards  30 50 - 50.1.4    PM AB-02-168 Part I Form CMS-R-131 Advance Beneficiary Notice (ABN)  30 50.2 - 50.2.6     When and to Whom an ABN Should Be Given  30 50.3 - 50.3.5     Delivery of the ABN  30 50.4 Choosing the ABN Form to Use  30 50.5 Form Instructions for ABN-G and ABN-L (Form CMS-R-131)  30 50.6 Signature Requirements  30 50.7 - 50.7.7     Special Rules  30 50.8 - 50.8.3   PM AB-02-168, Part III  Instructions for Fiscal Intermediaries and Providers on Advance Beneficiary Notice (ABN) Standards for Items and Services for Which Institutional Part B Claims Will Be Processed by Fiscal Intermediaries and on Limits on Beneficiary Liability for Medical Equipment and Supplies New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 30 50.9 - 50.9.3   PM AB-02-168, Part IV   Instructions for Regional Home Health Intermediaries (RHHIs) and Hospices on Advance Beneficiary Notice (ABN) Standards for Certain Hospice Claims 30                60 PM A-03-024,  PM A-03-025   Form CMS-R-296 Home Health Advance Beneficiary Notice (HHABN) 30 60.1 - 60.1.4     Basic Requirements for HHABNs  30 60.2 - 60.2.5     When and to Whom an HHABN Should Be Given  30 60.3 - 60.3.5     Delivery of HHABNs  30 60.4 - 60.4.4     Form Instructions for the HHABN (Form CMS-R-296) 30 60.5 Signature Requirements for HHABN  30 60.6 - 60.6.9.4     Special Rules for HHABNs  30 70 - 70.1.3 A3-3730.1    Form CMS-10055 Skilled Nursing Facility Advance Beneficiary Notice (SNFABN)
(Medicare Claims Processing Manual Crosswalk)
30 70.2 - 70.2.5     When and to Whom a SNFABN Should Be Given  30 70.3 - 70.3.5     Delivery of SNFABNs (Section heading only)  30 70.4 - 70.4.5     Form Instructions for the SNFABN (Form CMS-10055)  30 70.5 Signature Requirements for SNFABN  30 70.6 - 70.6.9.4     Special Rules for SNFABNs (Section heading only) New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 30                                               80 Hospital ABNs (Hospital-Issued Notices of Noncoverage - HINN) 30 80.1 - 80.1.6     When and to Whom a Hospital ABN Should Be Given 30 80.2 Issuing the Appropriate Hospital ABN 30 80.3 - 80.3.6     Hospital ABNs (HINNs) 30 80.4 - 80.4.3     Signature Requirements 30 80.5 QIO Review Authority for Hospital ABNs 30 80.6 - 80.6.2     QIO Monitoring of Hospital ABNs 30 80.7 Notices in Investigational/Experimental Procedures Situations 30 80.8 - 80.8.4     Beneficiary Liability 30 80.9 Provider Liability 30 80.10 - 80.10.1     Right to a Reconsideration 30 90 - 90.5     Form CMS-20007 - Notices of Exclusions From Medicare Benefits (NEMBs) 30 100 A3-3446 B3-7320 Indemnification Procedures for Claims Falling Within the Limitation on Liability Provision 30 100.1 A3-3446.1 B3-7320.1 Contractor and Social Security Office (SSO) Responsibility in Indemnification Claims 30 100.2 A3-3446.2 B3-7320.23,B3-7300.5 Conditions for Indemnification New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 30
(Medicare Claims Processing Manual Crosswalk)
100.3 A3-3446.3 B3-7320.3 Development and Documentation of Indemnification Requests 30 100.4 A3-3446.4 B3-7320.4 Beneficiary Requests Indemnification, but Had No Financial Interest in the Claim 30 100.5 A3-3446.5 B3-7320.5 Questionable Indemnification Requests Procedure 30 100.6 A3-3446.6 B3-7320.6 Determining the Amount of Indemnification 30 100.7 A3-3446.7 B3-7320.7 Notifying the Provider, Practitioner, or Supplier 30 100.8 A3-3446.8 B3-7320.8 Making Payment Under Indemnification 30 100.9 B3-7300.9 Limitation on Liability Determination Does Not Affect Medicare Exclusion 30 100.10 A3-3446.9 B3-7320.10  Exhibits 30 110 Contractor Instructions for Application of Limitation On Liability (Section heading only) 30 110.1 A3-3441 Payment Under Limitation on Liability 30 110.2 A3-3442 When to Make Limitation on Liability Decisions 30 110.3 A3-3443 Preparation of Denial Notices 30 110.4 A3-3445 Bill Processing 30 120 B3-7300,B3-7320.10 Carrier Specific Instructions for Application of Limitation on Liability (Section heading only) New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 30
(Medicare Claims Processing Manual Crosswalk)
120.1 B3-7300.6 Documentation of Notices Regarding Coverage 30 120.2 B3-7300.7 Availability of Coverage Notices to Operating Personnel 30 120.3 B3-7300.10  Applicability of Limitation on Liability Provision to Claims for Outpatient Physical Therapy Services Furnished by Clinics 30 120.4 B3-7300.4 Limitation on Liability Notices to Beneficiaries from Carriers 30 120.5 B3-7300.4B2 Carrier Reviews in Assignment Cases Conducted at the Request of Either the Beneficiary or the Assignee 30 120.5.1 B3-7300.4C Guide Paragraphs for Carriers to Use Where 1879 Is Applicable at Review Level 30 130 Intermediary Specific Instructions for Application of Limitation on Liability 30 130.1 A3-3444 Applicability of the Limitation on Liability Provision to Claims for Ancillary, Outpatient Provider and Rural Health Clinic Services Payable Under Part B 30 130.1.1 A3-3444.1 Determining Beneficiary Liability in Claims for Ancillary and Outpatient Services 30 130.1.2 A3-3444.2 Determining Provider Liability in Claims for Ancillary and Outpatient Services 30 130.2 A3-3431.1 Prior Hospitalization and Transfer Requirements for SNF Coverage as Related to Limitation on Liability New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 30            130.3 A3-3431.2 Application of Limitation on Liability to SNF and Hospital Claims for Services Furnished in Noncertified or Inappropriately Certified Beds 30 130.4 A3-3431.3 Determining Liability for Services Furnished in a Noncertified SNF or Hospital Bed 30 140 - 140.12 B3-7330    Physician Refund Requirements (RR) Provision for Nonassigned Claims for Physicians Services Under 1842(l) - Instructions for Carriers and Physicians 30 150 - 150.15    AB-02-168 Part I  DMEPOS Refund Requirements (RR) Provision for Claims for Medical Equipment and Supplies under 1834(a)(18), 1834(j)(4), and 1879(h) - Instructions for Carriers and Suppliers
clm104c31.pdf
Medicare Claims Processing Manual  Chapter 31 - ANSI X12 Formats Other than Claims or Remittance   Table of Contents  (Rev. 10236, 07- 31-20)  Transmittals for Chapter 31  10 - ASC X12 270/271 Health Care Eligibility Benefit Inquiry and Response Implementation  10.1 -  Background  10.2 -  Eligibility Connectivity Workflow  20 - ASC X12 276/277 Claims Status Request/Response Transaction Standard  20.1 -  Transmission Requirements  20.1.1 -  Batch Transactions  20.1.2 -  Online Direct Data Entry (DDE)  20.1.3 -  Interactive/Online (Non -DDE)  20.2 -  Summary of the ASC X12 276/277 Claim Status Request and Response Process for A/B Medicare Administrative Contractors, DME MACs, CEDI  20.3 -  Flat Files  20.4 -  Translation Requirements  20.5 -  Transmission Mode  20.6 -  Restriction and Controlling Access to Claims Status Information  20.7 -  Health Care Claim Status Category Codes and Health Care Claim Status Codes for Use with the Health Care Claim Status Request and Response ASC X12 276/277 Claim Status Request and Response   10 - ASC X12 270/271 Health Care Eligibility Benefit Inquiry and Response Implementation  (Rev. 2937, Issued; 04- 25-14, Effective: 04- 14-14, Implementation: 04- 14-14)  10.1 - Background  (Rev. 2937, Issued; 04- 25-14, Effective: 04- 14-14, Implementation: 04- 14-14)  This section provides information on Medicares implementation of the Accredited Standards Committee (ASC) X12 Health Care Eligibility Benefit Inquiry and Response (270/271) transaction (short reference: ASC X12 270/271 eligibility transaction).  The CMS supports the currently mandated version of the transaction based upon the currently mandated version of the ASC X12 Standards for Electronic Data Interchange Technical Report Type 3 --Health Care Eligibility Benefit Inquiry and Response (270/271), both of which were adopted as the National standard for the health care eligibility benefit inquiry and response under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The technical report 3 is also known as a TR3 or implementation guide (IG) . (Refer to chapter 24 for current versions adopted under HIPAA.)
clm104c31.pdf
10.2 -Eligibility Connectivity Workflow  (Rev. 10236, Issued: 07- 31-2020, Effective: 08- 31-2020, Implementation: 08- 31-2020)   In 2005, the Centers for Medicare & Medicaid Services (CMS) impl emented the HIPAA Eligibility Transaction System (HETS 270/271)  to address the standards for the Medicare beneficiary eligibility inquiries, creating a centralized ASC X12 270/271 health care eligibility inquiry  application that can process eligibility transactions in real -time.  For information regarding HETS connectivity, visit the HETS Help web site.   http://www.cms.gov/Research- Statistics -Data -and-Systems/CMS -Information-Technology/HETSHelp/index.html   20 - ASC X12 276/277 Claims Status Request/Response Transaction Standard  (Rev. 10236, Issued: 07- 31-2020, Effective: 08- 31-2020, Implementation: 08- 31-2020)   These instructions apply to Medicare Administrative Contractors (MACs), Durable Medical Equipment Medicare Administrative Contractors  (DME MACs), the Common Electronic Data Interchange (CEDI) contractor for DME MACs, and their shared systems on Medicare requirements for their implementation of the current HIPAA compliant version of the ASC X12 Health Care Claim Status Request and Response (276/277) transaction (short reference: ASC X12 276/277 claim status request and response.)   CMS supports the current version of this transaction as established in its TR3 adopted under HIPAA: the ASC X12 Standards for Electronic Data Interchange Techni cal Report Type 3 Health Care Claim Status Request and Response (276/277).