Import ›
271 Response
Eligibility Response Detail
CIN: YS09038P
Date of Service: Aug. 6, 2026
Submitted: Aug. 9, 2026 3:45 PM
Payload ID: 864797b3-f144-4174-956b-e4edda968d4a
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: SOUTHWEST BROOKLYN HEALTH HOME LLC
Received: Aug. 9, 2026 3:45 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2027-04-30 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| 1 | 88 | — | — | — | |
| W | CQ | — | — | — | |
| W | CQ | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260809*1945*|*00501*304751246*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*1945*751246*X*005010X279A1~ST*270*1246*005010X279A1~BHT*0022*13*202608091945000001*20260809*1945~HL*1**20*1~NM1*PR*2*NYSDOH*****PI*EMEDNY~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~PRV*PE*PXC*251B00000X~HL*3*2*22*0~TRN*1*202608091945000001*00000000ND~NM1*IL*1******MI*YS09038P~EQ*30~DTP*291*D8*20260806~SE*13*1246~GE*1*751246~IEA*1*304751246~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260809*1545*^*00501*311918530*0*P*|~GS*HB*EMEDNYREL*00ND*20260809*154547*311918530*X*005010X279A1~ST*271*311918530*005010X279A1~BHT*0022*11*202608091945000001*20260809*154547~HL*1**20*1~NM1*PR*2*NYSDOH*****FI*141797357~PER*IC*EMEDNY PROVIDER SERVICES*TE*8003439000*UR*www.emedny.org~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~HL*3*2*22*0~TRN*2*202608091945000001*00000000ND~NM1*IL*1*CABA*RAFAELA****MI*YS09038P~N3*311 HINSDALE STREET~N4*BROOKLYN*NY*11207~DMG*D8*19360409*F~DTP*472*D8*20260809~DTP*346*D8*20260801~DTP*102*D8*20260601~EB*U*IND*30**ELIGIBLE PCP~MSG*A1~MSG*A2~MSG*CF~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=04~LS*2120~NM1*Y2*2*VNS CHOICE PARTIAL LTC*****PI*VC~N3*220 E 42ND ST FL 6~N4*NEW YORK*NY*100175831~PER*IC*PROVIDER SERVICES*TE*8667830222~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*W*IND*CQ~LS*2120~NM1*Y2*2*DORAL MEDICAL & MULTI SPECIALTY FAC*****XX*1144693607~LE*2120~EB*W*IND*CQ~LS*2120~NM1*Y2*2*SOUTHWEST BROOKLYN HEALTH HOME LLC*****XX*1023354933~LE*2120~EB*R*IND*30~REF*6P*H3359~LS*2120~NM1*P4*2*HEALTHFIRST MEDICARE PLAN*****PI*H3359~N3*HEALTHFIRST MEDICARE PLAN PO BOX 5165~N4*NEW YORK*NY*10274~PER*IC*PROVIDER SERVICES*TE*8882601010~LE*2120~EB*R*IND*30~REF*18*7WX4ER6XN67~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*53*311918530~GE*1*311918530~IEA*1*311918530~