Health Benefit Exchange (HBE) Interfaces

Created on: 
Jun 05 2015

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

What are the Healthcare Benefit Exchange (HBE) interfaces?

The HBE interfaces communicate data between ACES, the Eligibility Service (EServ) and the HBE to support eligibility determination and Medicaid expansion as required under the Affordable Care Act (ACA) of 2010. The required data is sent or received through the following interfaces or files:

  • The Eligibility Service Request (Inbound) – This interface receives data elements required for eligibility determination from HBE.
  • Eligibility Service Response (Outbound) – This interface sends data elements required for communicating eligibility results back to HBE.
  • Request for Inquiry Service (Outbound) – This interface is to communicate the eligibility changes that take place in EServ and need to be updated in HBE.
  • ACES to HBE Conversion File – This conversion file contains file layouts to transfer or convert existing active eligible ACES Medicaid client data to HBE. This facilitates an easier application and renewal process for clients.
  • HBE – This data file is sent to the HBE notifying of any eligibility changes to MAGI clients due to changes made to ACES data. This is to ensure data remains in sync between EServ and HBE.
  • HBE Data for Post Enrollment Review - This is a daily batch process interface from ACES to Health Care Authority (HCA).  This interface provides HCA with information for Modified Adjusted Gross Income (MAGI) households that have income determined by EServ as not having reasonable compatibility to state or federal verification sources. 

Online Processing

This interface does not require any Online Processing.

Mainframe Processing

This interface does not require any Mainframe Processing.

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.