CMS-10157. Crosswalk

TPA4.1- Crosswalk.xls

The HIPAA Eligibility Transaction System (HETS) (CMS-10157)

CMS-10157. Crosswalk

OMB: 0938-0960

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# Form Change Current Location Reason
1 TPA 4.1 Changed the format of collection of Offshore Location organization name and Address. The new format is tablular form to collect each org name, address in a single row for ease of collection of data. P.11 formatting/rearrange fields for ease of collection of data instead of collecting all org names in a single cell.
2 TPA 4.1 Added the offshore Organization IP address field P.11 To protect the beneficiary data by controlling/allowing the traffic from these IP address which will be provided on this revised form.
File Typeapplication/vnd.ms-excel
Authorowner
Last Modified ByRupinder Singh
File Modified2021-11-09
File Created2010-07-12

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