Last Modified: 12/13/2017 Location: FL, PR, USVI Business: Part A, Part B
Eligibility report: Error message FAQ
Q: Why am I getting an error message when generating a SPOT eligibility report?
A: When you submit an eligibility query through SPOT, you are connecting with HIPAA Eligibility Transaction System (HETS). The SPOT application serves as the interface between the user and HETS. Information available through HETS is updated during quarterly releases as appropriate. This release may include an update to the beneficiary’s health insurance claim number (HICN).
When the system contains updated information, SPOT will display the new HICN within the error message on the eligibility form. Please update the beneficiary’s record and use the new HICN on all inquiries going forward.
Note: If you have the correct HICN and continue to receive an error message after submitting an eligibility query, the message is generated from HETS. Check to make sure that you have no spaces before or after data entered in required fields. However, during high volume periods, HETS may return an error message erroneously, or your query may “time out” due to slower than normal response times.
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