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HIPAA Eligibility Transaction System (HETS) Provider Attestation FAQs

Updated: 05/14/2026|Views: 6257

HETS provider attestation is a new annual requirement mandated by the Centers for Medicare and Medicaid Services (CMS) for providers to authorize third-party entities such as clearinghouses to access the HETS for Medicare eligibility transactions.

Starting on May 11, 2026, active HETS EDI enrollment (attestation) is required for each Billing NPI a clearinghouse submits through the HETS. Without an active enrollment, Medicare eligibility requests will reject.

Answers to the most common HETS provider attestation questions.

Question Answer
What is the HIPAA Eligibility Transaction System (HETS)? The Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS) allows entities to exchange real-time, HIPAA compliant Medicare eligibility transactions over a secure connection. Visit the CMS website to learn more about the HETS.
What is HETS provider attestation and its purpose? HETS provider attestation, also referred to as HETS Electronic Data Interchange (EDI) enrollment, is a new annual requirement mandated by the Centers for Medicare and Medicaid Services (CMS) for providers to authorize third-party entities such as clearinghouses to access the HETS for Medicare eligibility transactions. This security measure establishes known trading relationships between entities' HETS Submitter Unique IDs and providers' NPIs to ensure only authorized parties access patient data.
Is HETS provider attestation required? Yes. To ensure continued access to the HETS for Medicare eligibility transactions, all providers must attest.
Can Tebra complete HETS provider attestation on behalf of the provider? No. HETS provider attestation must be completed directly through the provider's applicable Medicare Administrative Contractor (MAC) portal(s).
How can providers complete and submit the HETS provider attestation? Providers can submit HETS provider attestation through their applicable MAC portal(s). For convenience, MAC links are provided in the MAC HETS EDI Enrollment/Provider Attestation Links section. Visit the CMS website to learn more about how to enroll.
When do providers need to complete HETS provider attestation? The deadline for providers to complete HETS provider attestation was May 11, 2026.

Starting on May 11, 2026, Medicare eligibility requests will reject for providers without an active HETS EDI enrollment (attestation) for each Billing NPI a clearinghouse submits through the HETS.
What Medicare eligibility request rejections return for providers that did not complete HETS provider attestation by May 11, 2026? Providers that did not complete attestation may receive the following Medicare eligibility request rejections.
  • Trizetto: Authorization/Access Restrictions - The NPI submitted is not enrolled to check eligibility for this payer.
  • Eligible API, Practice Insights (Waystar), and Inovalon (Change Healthcare): AAA*51 Provider Not on File
  • Stedi: AAA Error Code 41 Authorization/Access Restrictions
What are HETS Submitter Unique IDs? HETS Submitter Unique IDs are assigned by CMS to third-party entities (such as clearinghouses) that submit Medicare eligibility transactions, identifying them in the system. These IDs are used by providers to authorize clearinghouses in their HETS EDI enrollment (attestation).
What are the HETS Submitter Unique IDs used to attest to Tebra's clearinghouse relationships? Providers that submit Medicare eligibility transactions through Tebra need to attest to all of the following HETS Submitter Unique IDs used for Tebra's clearinghouse relationships.
  • Eligible API: YAZN
  • Trizetto: WBQL
  • Stedi: 274B
  • Inovalon (Change Healthcare): VQAS
  • Practice Insights (Waystar): YGTG
Who can providers contact for further assistance? For MAC portal and/or additional provider attestation questions, contact the MCARE Help Desk.

MAC HETS EDI Enrollment/Provider Attestation Links

Providers can submit HETS provider attestation through their applicable MAC portal(s) using the links provided in the below table.

MAC - Jurisdiction & State/Territory Assignment HETS EDI Enrollment/Provider Attestation Link
CEDI - JA, JB, JC, or JD
Note: EDI connectivity only. There is no assignment.
HETS CEDI Enrollment Form
National Government Services (NGS) - J6 Home Health and Hospice (HH&H)
Assignment: Illinois, Minnesota, Wisconsin
NGS HETS EDI Enrollment Form
National Government Services (NGS) - JK Home Health and Hospice (HH&H)
Assignment: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont
NGS HETS EDI Enrollment Form
Noridian EDISS - JE
Assignment: California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands
EDISS Connect: HETS Attestations Guide (PDF)
Noridian EDISS - JF
Assignment: Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming
EDISS Connect: HETS Attestations Guide (PDF)
Novitas - JH
Assignment: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas
Medicare JH HETS - EDI Enrollment Tool (HEET)
Novitas - JL
Assignment: Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania
Medicare JL HETS - EDI Enrollment Tool (HEET)
First Coast Service Options - JN
Assignment: Florida, Puerto Rico, U.S. Virgin Islands
FCSO HETS - EDI Enrollment Tool (HEET)
Palmetto GBA - JJ Part A
Assignment: Alabama, Georgia, Tennessee
JJ Part A HETS Provider Attestation
Palmetto GBA - JJ Part B
Assignment: Alabama, Georgia, Tennessee
JJ Part B HETS Provider Attestation
Palmetto GBA - JM Part A
Assignment: North Carolina, South Carolina, Virginia, West Virginia
JM Part A HETS Provider Attestation
Palmetto GBA - JM Part B
Assignment: North Carolina, South Carolina, Virginia, West Virginia
JM Part B HETS Provider Attestation
Palmetto GBA - JM Home Health and Hospice (HH&H)
Assignment: North Carolina, South Carolina, Virginia, West Virginia
JM HHH HETS Provider Attestation
CGS - J15 Part A
Assignment: Kentucky, Ohio
J15 Part A EDI Enrollment: HETS EDI Enrollment Form
CGS - J15 Part B
Assignment: Kentucky, Ohio
J15 Part B EDI Enrollment: HETS EDI Enrollment Form
CGS - J15 Home Health and Hospice (HH&H)
Assignment: Kentucky, Ohio
J15 HHH EDI Enrollment: HETS EDI Enrollment Form
WPS - J5
Assignment: Iowa, Kansas, Missouri, Nebraska
WPS CMS HETS Enrollment/Provider Attestation
WPS - J8
Assignment: Indiana, Michigan
WPS CMS HETS Enrollment/Provider Attestation

 

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