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271 Response
Eligibility Response Detail
CIN: WA20729P
Date of Service: Aug. 6, 2026
Submitted: Aug. 9, 2026 3:51 PM
Payload ID: 8bfe6241-0ca3-4c16-8fc6-94eaea7197ee
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: COMMUNITY CARE MANAGEMENT PARTNERS
Received: Aug. 9, 2026 3:51 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2026-11-30 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| W | CQ | — | — | — | |
| W | CQ | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260809*1951*|*00501*305101629*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*1951*101629*X*005010X279A1~ST*270*1629*005010X279A1~BHT*0022*13*202608091951000001*20260809*1951~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*202608091951000001*00000000ND~NM1*IL*1******MI*WA20729P~EQ*30~DTP*291*D8*20260806~SE*13*1629~GE*1*101629~IEA*1*305101629~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260809*1551*^*00501*314929930*0*P*|~GS*HB*EMEDNYREL*00ND*20260809*155137*314929930*X*005010X279A1~ST*271*314929930*005010X279A1~BHT*0022*11*202608091951000001*20260809*155137~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*202608091951000001*00000000ND~NM1*IL*1*LIND*LIDIYA****MI*WA20729P~N3*815 GRAVESEND NECK ROAD 3J~N4*BROOKLYN*NY*11223~DMG*D8*19511023*F~DTP*472*D8*20260809~DTP*346*D8*20260801~DTP*102*D8*20260201~EB*U*IND*30**ELIGIBLE PCP~MSG*A1~MSG*A2~MSG*CF~MSG*PD~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=11~LS*2120~NM1*Y2*2*ELDERSERVE HEALTH INC MAP*****PI*EA~N3*80 W 225TH ST FL 3~N4*BRONX*NY*104637002~PER*IC*PROVIDER SERVICES*TE*8003703600~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*W*IND*CQ~LS*2120~NM1*Y2*2*JEMCARE LLC*****XX*1265926216~LE*2120~EB*W*IND*CQ~LS*2120~NM1*Y2*2*COMMUNITY CARE MANAGEMENT PARTNERS*****XX*1366780850~LE*2120~EB*R*IND*30~REF*6P*H6776~LS*2120~NM1*P4*2*ELDERSERVE HEALTH INC*****PI*H6776~N3*94 WEST 225TH STREET 2ND FLOOR~N4*BRONX*NY*10463~PER*IC*PROVIDER SERVICES*TE*8887778279~LE*2120~EB*R*IND*30~REF*18*5HT5CA2DP64~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*53*314929930~GE*1*314929930~IEA*1*314929930~