CMS EDI Implementation History

Background

In 2003 Medicare started testing the HIPAA compliant CMS 270 Inquiry and 271 Response system. In December of 2003 they halted the program.

Data Centers unable to handle the projected volume.

The reason for the suspension was that the first 270 Real Time process method relied on the 9 different data centers mainframes real time translations of submitted 270s via streaming socket connections and returning 271 response through the same socket. After some high volume testing, it was determined that the data centers were unable to handle the projected volume.

CMS suspended the testing because the IP protocol 270 submissions consumed almost all the processing capabilities of the existing SNA protocol based traffic. It almost shut down the 3270 terminal emulation Direct Data Entry (DDE) access.

This shut down was done with just a small volume of the potential volume generated by the

• 6,200 hospitals,
• 850,000 professionals, i.e. physicians, chiropractors, etc.
• 173,000 labs and
• 41,700 HMOs,Long Term Care facilities and others.

After nearly a year during which time CMS re-designed, tested and finally went into production accepting 270/271 transactions. At 2:38:41 CST October 13, 2005 , American Health Data Services (AHDS) sent AHDS' first CMS formatted 270 inquiry receiving back a 271 document.

AHDS was one of the first organizations to send transactions to Medicare HIPAA Eligibility Transaction System (HETS 270/271) located in Baltimore MD, on a 24/7 basis.

As of February 12, 2009 AHDS has sent 3,805,877 transactions.